title: Efficacy of the anal fistula plug in complex anorectal fistulae.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: John Goligher Colorectal Unit, General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: D K
authors.initials: DK
authors.lastname: Thekkinkattil
authors.forename: I
authors.initials: I
authors.lastname: Botterill
authors.forename: N S
authors.initials: NS
authors.lastname: Ambrose
authors.forename: L
authors.initials: L
authors.lastname: Lundby
authors.forename: P M
authors.initials: PM
authors.lastname: Sagar
authors.forename: S
authors.initials: S
authors.lastname: Buntzen
authors.forename: P J
authors.initials: PJ
authors.lastname: Finan
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D001684:Biological Dressings; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012003:Rectal Fistula / Q000601:surgery; D012006:Rectovaginal Fistula / Q000601:surgery*; D013536:Suture Techniques; D017211:Treatment Failure; D055815:Young Adult