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Efficacy of Anal Fistula Plug in Closure of Cryptoglandular Fistulas: Long-Term Follow-Up

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Purpose

The long-term efficacy of Surgisis® anal fistula plug in closure of cryptoglandular anorectal fistulas was studied.

Methods

Patients with high cryptoglandular anorectal fistulas were prospectively studied. Additional variables recorded were: number of fistula tracts, and presence of setons. 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, which was securely sutured in place at the primary opening and tacked to the periphery of the secondary opening.

Results

Forty-six patients were prospectively enrolled during a two-year period. Follow-up was six months to two years (median, 12 months). At final follow-up, all fistula tracts had been successfully closed in 38 patients, for an overall success rate of 83 percent. Seven patients had multiple tracts, for a total of 55 fistula tracts in the series. Of the 55 individual tracts, 47 (85 percent) were closed at final follow-up. Patients with one primary opening were most likely to have successful closure by using the anal fistula plug, although this was not significant. Successful closure was not correlated with the presence of setons.

Conclusions

Long-term closure of cryptoglandular anorectal fistula tracts using Surgisis® anal fistula plug is safe and successful in 83 percent of patients and 85 percent of tracts.

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References

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

    Article  PubMed  Google Scholar 

  2. GN Buchanan CI Bartram RK Phillips et al. (2003) ArticleTitleEfficacy of fibrin sealant in the management of complex anal fistulas Dis Colon Rectum 46 1167–1174 Occurrence Handle12972959 Occurrence Handle10.1007/s10350-004-6708-9

    Article  PubMed  Google Scholar 

  3. SM Sentovic (2003) ArticleTitleFibrin glue for anal fistulas Dis Colon Rectum 46 498–502 Occurrence Handle10.1007/s10350-004-6589-y

    Article  Google Scholar 

  4. I Lindsey MM Smilgin-Humphreys C Cunningham NJ Mortensen B George (2002) ArticleTitleA randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistula Dis Colon Rectum 45 1608–1615 Occurrence Handle12473883 Occurrence Handle10.1007/s10350-004-7247-0

    Article  PubMed  Google Scholar 

  5. M Singer J Cintron R Nelson et al. (2005) ArticleTitleTreatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or closure of the internal fistula opening Dis Colon Rectum 48 799–808 Occurrence Handle15785883 Occurrence Handle10.1007/s10350-004-0898-z

    Article  PubMed  Google Scholar 

  6. J Cintron JJ Park CP Orsay et al. (2000) ArticleTitleRepair of fistulas-in-ano using fibrin adhesive: long-term follow-up Dis Colon Rectum 43 944–949 Occurrence Handle10910240 Occurrence Handle1:STN:280:DC%2BD3czmsFKisg%3D%3D Occurrence Handle10.1007/BF02237355

    Article  PubMed  CAS  Google Scholar 

  7. SF Badylak (2002) ArticleTitleThe extra cellular 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 

  8. 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 

  9. J Garcia-Aguilar CS Davey CT Le AC Lowry DA Rothenberger (2000) ArticleTitlePatient satisfaction after surgical treatment for fistula-in-ano Dis Colon Rectum 43 1206–1212 Occurrence Handle11005484 Occurrence Handle1:STN:280:DC%2BD3cvltVGjsg%3D%3D Occurrence Handle10.1007/BF02237422

    Article  PubMed  CAS  Google Scholar 

  10. DD Zimmermann JW Briel MP Gosselink WR Schouten (2001) ArticleTitleAnocutaneous advancement flap repair of transsphincteric fistulas Dis Colon Rectum 44 1474–1480 Occurrence Handle10.1007/BF02234601

    Article  Google Scholar 

  11. T Sonoda T Hull MR Piedmonte VW Fazio (2002) ArticleTitleOutcomes of primary repair of anorectal and rectovaginal fistulas using endorectal advancement flap Dis Colon Rectum 45 1622–1628 Occurrence Handle12473885 Occurrence Handle10.1007/s10350-004-7249-y

    Article  PubMed  Google Scholar 

  12. WR Schouten DD Zimmermann JW Briel (1999) ArticleTitleTransanal advancement flap repair of transsphincteric fistula Dis Colon Rectum 42 1419–1423 Occurrence Handle10566529 Occurrence Handle1:STN:280:DC%2BD3c%2FjtVyjtw%3D%3D Occurrence Handle10.1007/BF02235039

    Article  PubMed  CAS  Google Scholar 

  13. NM Mizrahi SD Wexner O Zmora (2002) ArticleTitleEndorectal advancement flap. Are there predictors of failure? Dis Colon Rectum 45 1616–1621 Occurrence Handle12473884 Occurrence Handle10.1007/s10350-004-7248-z

    Article  PubMed  Google Scholar 

  14. CB Tsang RD Madoff WD Wong et al. (1998) ArticleTitleAnal sphincter integrity and function influences outcome in rectovaginal fistula repair Dis Colon Rectum 41 1141–1146 Occurrence Handle9749498 Occurrence Handle1:STN:280:DyaK1cvhvF2htQ%3D%3D Occurrence Handle10.1007/BF02239436

    Article  PubMed  CAS  Google Scholar 

  15. WR Schouten DD Zimmermann HD Briel (1999) ArticleTitleTransanal advancement flap repair of transsphincteric fistulas Dis Colon Rectum 42 1419–1423 Occurrence Handle10566529 Occurrence Handle1:STN:280:DC%2BD3c%2FjtVyjtw%3D%3D Occurrence Handle10.1007/BF02235039

    Article  PubMed  CAS  Google Scholar 

  16. T Ueno LC Pickett SG Feunte Particlede la DC Lawson TN Pappas (2004) ArticleTitleClinical applications 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 

  17. ME Franklin JJ Gonzalez 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 

  18. WS Helton PM Fisichella R Berger et al. (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 

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Authors and Affiliations

Authors

Corresponding author

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

Additional information

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

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Cite this article

Champagne, B.J., O’Connor, L.M., Ferguson, M. et al. Efficacy of Anal Fistula Plug in Closure of Cryptoglandular Fistulas: Long-Term Follow-Up. Dis Colon Rectum 49, 1817–1821 (2006). https://doi.org/10.1007/s10350-006-0755-3

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