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Gore Bio‐A ® Fistula Plug: a new sphincter‐sparing procedure for complex anal fistula
Author(s) -
Ratto C.,
Litta F.,
Parello A.,
Donisi L.,
Zaccone G.,
De Simone V.
Publication year - 2012
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.1463-1318.2012.02964.x
Subject(s) - medicine , anal fistula , anal sphincter , fistula , surgery , rectal fistula , sphincter
Aim The surgical treatment of a complex anal fistula remains controversial, although ‘sphincter‐saving’ operations are desirable. The Gore Bio‐A ® Fistula Plug is a new bioprosthetic plug that has been proposed for the treatment of complex anal fistula. This study reports preliminary data following implantation of this plug. Method Eleven patients with a complex anal fistula underwent insertion of Gore Bio‐A ® Fistula Plugs. The disc diameter and number of tubes in the plug were adapted to the fistula to allow accommodation of the disc into a submucosal pocket, and the excess tubes were trimmed. During the follow‐up period, patients underwent clinical and physical examinations and three‐dimensional endoanal ultrasound. Results Fistulas were high anterior transphincteric in five patients and high posterior transphincteric in six patients. All patients had a loose seton placement before plug insertion. Two, three and four tubes were inserted into the fistula plug in seven, three and one patient, respectively. The median follow‐up period was 5 months. No patient reported any faecal incontinence. There was no case of early plug dislodgement. Treatment success was noted for eight (72.7%) of 11 patients at the last follow‐up appointment. Conclusion Implanting a Gore Bio‐A ® Fistula Plug is a simple, minimally invasive, safe and potentially effective procedure to treat complex anal fistula. Patient selection is fundamental for success.