To determine the efficacy of anal fistula plug in the treatment of high fistula-in-ano: an initial experience.
OBJECTIVE
The aim of this study was to determine the efficacy of the anal fistula plug in the treatment of high fistula-in-ano.


METHODS
Twenty-three patients with high cryptoglandular fistula-in-ano were prospectively studied over 1 year. The number of tracks, number of previous procedures and co-morbid conditions that could potentially affect outcome were noted. A seton was used to guide the AFP into the fistula track which was anchored at the primary opening.


RESULTS
Two patients were lost to follow-up. Twenty-one patients (mean age was 49.8 years) were followed from 192 to 543 days (median = 292 days). Thirteen patients had single track, eight had multiple tracks and 14 had a recurrent fistula. Success, defined by closure of all fistula tracks occurred in 71.4% (15/21). The success rate was 84.6% in patients with a single fistula track (11/13) compared with 50% in patients with multiple tracks (4/8) (P = 0.14, Fisher's exact test). Recurrent [10/14 (71.4%)] vs nonrecurrent fistulae [5/7 (71.4%)] had no bearing on the outcome (P = 1.0). Two patients experienced healing despite extrusion of the plug in the early postoperative period. The procedure was safe and well tolerated.


CONCLUSIONS
The Surgisis AFP was successful in 71.4% of patients. Plug extrusion does not necessarily mean failure.
Garg
P
P
Department of General Surgery, Fortis Super-Specialty Hospital, Mohali, Chandigarh, India. drgargpankaj@yahoo.com
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012003:Rectal Fistula / Q000601:surgery*; D016896:Treatment Outcome