Skip to main content
SpringerLink
Log in

Efficacy of Anal Fistula Plug in Closure of Crohn’s Anorectal Fistulas

  • Published:
Diseases of the Colon & Rectum

Purpose

The efficacy of Surgisis® anal fistula plug in closure of Crohn’s anorectal fistula was studied.

Methods

Patients with Crohn’s anorectal fistulas were prospectively studied. Diagnosis was made by histologic, radiographic, or endoscopic criteria. Variables recorded were: number of fistula tracts (primary openings), presence of setons, and current antitumor necrosis factor therapy. Under general anesthesia and in prone jackknife position, patients underwent irrigation of the fistula tract by using hydrogen peroxide. Each primary opening was occluded by using a Surgisis® anal fistula plug. Superficial tracts amenable to fistulotomy were excluded.

Results

Twenty consecutive patients were prospectively enrolled, comprising a total of 36 fistula tracts. At final follow-up, all fistula tracts had been successfully closed in 16 of 20 patients, for an overall success rate of 80 percent. Thirty of 36 individual fistula tracts (83 percent) were closed at final follow-up. Patients with single fistulas (with 1 primary opening) were most likely to have successful closure using the anal fistula plug. Successful closure was not correlated with the presence of setons or antitumor necrosis factor therapy.

Conclusions

Closure of Crohn’s anorectal fistula tracts using Surgisis® anal fistula plug is safe and successful in 80 percent of patients and 83 percent of fistula tracts. Closure rates were higher with single tracts than complex fistulas with multiple primary openings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. PR Williamson MD Hellinger SW Larach A Ferrara (1995) ArticleTitleTwenty-year review of the surgical management of perianal Crohn’s disease Dis Colon Rectum 38 389–392 Occurrence Handle7720446 Occurrence Handle1:STN:280:ByqB3snos1I%3D Occurrence Handle10.1007/BF02054227

    Article  PubMed  CAS  Google Scholar 

  2. CG Marks JK Ritchie HE Lockhart-Mummery (1981) ArticleTitleAnal fistulas in Crohn’s disease Br J Surg 68 525–527 Occurrence Handle7272665 Occurrence Handle1:STN:280:Bi2D3c7ivFY%3D

    PubMed  CAS  Google Scholar 

  3. JG Williams DA Rothenberger FD Nemer SM Goldberg (1991) ArticleTitleFistula-in-ano in Crohn’s disease: results of aggressive surgical treatment Dis Colon Rectum 34 378–384 Occurrence Handle2022142 Occurrence Handle1:STN:280:By6B3Mrps1U%3D Occurrence Handle10.1007/BF02053687

    Article  PubMed  CAS  Google Scholar 

  4. RD Fry EI Shemesh IJ Kodner A Timmcke (1981) ArticleTitleTechniques and results in the management of anal and perianal Crohn’s disease Surg Gynecol Obstet 168 42–48

    Google Scholar 

  5. JG Morrison JB Gathright SuffixJr JE Ray BT Ferrari TC Hicks (1989) ArticleTitleSurgical management of anorectal fistulas in Crohn’s disease Dis Colon Rectum 32 492–496 Occurrence Handle2791786 Occurrence Handle1:STN:280:By%2BD3cvnsFI%3D

    PubMed  CAS  Google Scholar 

  6. M Thornton MJ Solomon (2005) ArticleTitleLong-term indwelling setons for complex anal fistulas in Crohn’s disease Dis Colon Rectum 48 459–463 Occurrence Handle15719188 Occurrence Handle10.1007/s10350-004-0830-6

    Article  PubMed  Google Scholar 

  7. AA Bodegraven Particlevan CE Sloots RJ Felt-Bersma SG Meuwissen (2002) ArticleTitleEndosonographic evidence of persistence of Crohn’s disease-associated fistulas after infliximab treatment, irrespective of clinical response Dis Colon Rectum 45 39–45 Occurrence Handle11786762 Occurrence Handle10.1007/s10350-004-6111-6

    Article  PubMed  Google Scholar 

  8. DH Present P Rutgeers S Targan et al. (1999) ArticleTitleInfliximab for the treatment of fistulas in patients with Crohn’s disease N Engl J Med 340 1398–1405 Occurrence Handle10228190 Occurrence Handle1:CAS:528:DyaK1MXjtF2mu74%3D Occurrence Handle10.1056/NEJM199905063401804

    Article  PubMed  CAS  Google Scholar 

  9. EK Johnson JU Gaw DN Armstrong (2006) ArticleTitleEfficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas Dis Colon Rectum 49 371–376 Occurrence Handle16421664 Occurrence Handle10.1007/s10350-005-0288-1

    Article  PubMed  Google Scholar 

  10. SF Badylak (2002) ArticleTitleThe extracellular matrix as a scaffold for tissue reconstruction Semin Cell Dev Biol 13 377–383 Occurrence Handle12324220 Occurrence Handle1:CAS:528:DC%2BD38Xnt1agu7w%3D Occurrence Handle10.1016/S1084952102000940

    Article  PubMed  CAS  Google Scholar 

  11. SF Badylak (1993) Small intestinal submucosa (SIS): a biomaterial conducive to smart tissue remodeling E Bell (Eds) Tissue engineering: current perspectives Burkhauser Publishers Cambridge 179–189

    Google Scholar 

  12. T Ueno LC Pickett SG Feunte Particlede la DC Lawson TN Pappas (2004) ArticleTitleClinical application of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defects J Gastrointest Surg 8 109–112 Occurrence Handle14746842 Occurrence Handle10.1016/j.gassur.2003.09.025

    Article  PubMed  Google Scholar 

  13. ME Franklin SuffixJr JJ Gonzalez SuffixJr JL Glass (2004) ArticleTitleUse of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up Hernia 8 186–189 Occurrence Handle14991410

    PubMed  Google Scholar 

  14. WS Helton PM Fisichella R Berger S Horgan NJ Espat H Abcarian (2005) ArticleTitleShort-term outcomes with small intestinal submucosa for ventral abdominal hernia Arch Surg 140 549–562 Occurrence Handle15967902 Occurrence Handle10.1001/archsurg.140.6.549

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Georgia Colon and Rectal Surgical Clinic, 5555 Peachtree Dunwoody Road, Atlanta, 30342, Georgia, USA

    Lynn O’Connor M.D., Bradley J. Champagne M.D., Martha A. Ferguson M.D., Guy R. Orangio M.D., Marion E. Schertzer M.D. & David N. Armstrong M.D., F.R.C.S.

Authors
  1. Lynn O’Connor M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bradley J. Champagne M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martha A. Ferguson M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guy R. Orangio M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marion E. Schertzer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David N. Armstrong M.D., F.R.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David N. Armstrong M.D., F.R.C.S..

Additional information

Dr. David Armstrong has a patent‐licensing agreement with the manufacturer of Surgisis® (Cook Surgical, Inc., Bloomington, IN).

About this article

Cite this article

O’Connor, L., Champagne, B.J., Ferguson, M.A. et al. Efficacy of Anal Fistula Plug in Closure of Crohn’s Anorectal Fistulas. Dis Colon Rectum 49, 1569–1573 (2006). https://doi.org/10.1007/s10350-006-0695-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-006-0695-y

Key words

Search

Navigation