Premium
Efficacy of the anal fistula plug in complex anorectal fistulae
Author(s) -
Thekkinkattil D. K.,
Botterill I.,
Ambrose N. S.,
Lundby L.,
Sagar P. M.,
Buntzen S.,
Finan P. J.
Publication year - 2009
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2008.01627.x
Subject(s) - medicine , fistulotomy , anal fistula , surgery , fistula , rectovaginal fistula , pouch , fibrin glue , abscess
Objective The treatment of complex anorectal and rectovaginal fistulae remains a difficult problem. The options are fistulotomy, setons, fibrin glue and a variety of flap procedures. Recently, there have been several reports of a new plug; the Surgisis® AFP™ plug. Reports from various centres do not give consistent results. The aim of this study was to assess the efficacy of the Surgisis® AFP™ fistula plug in a wide spectrum of patients with anorectal, rectovaginal and pouch vaginal fistulae. Method Between March 2006 and September 2007, patients with a variety of anal fistulae were selected for fistula plug insertion in the coloproctology units at Leeds, UK, and Aarhus, Denmark. Demographic and fistulae details were obtained. Postoperatively, all patients had a course of oral antibiotics. Results Forty‐three patients with a median age of 45 (range 18–65) years underwent a total of 45 procedures. Seventy‐five per cent ( n = 32) had a fistula secondary to cryptoglandular abscess. Median follow up was 47 (range 12–77) weeks. The success rate for complete healing was 44%. Dislodgement caused failure on 10 (22%) occasions. Conclusion Our study shows a moderate success rate for treatment with fistula plugs. The complex nature of the fistulae selected may be the reason for the low success rate.