Efficacy of the anal fistula plug in complex anorectal fistulae.
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.
Thekkinkattil
D K
DK
John Goligher Colorectal Unit, General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Botterill
I
I
Ambrose
N S
NS
Lundby
L
L
Sagar
P M
PM
Buntzen
S
S
Finan
P J
PJ
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