title: A retrospective review of chronic anal fistulae treated by anal fistulae plug.
abstract: OBJECTIVE
  The aim of this study was to analyse the efficacy of the anal fistulae plug (Cook Surgisis AFP) for the management of complex anal fistulae.
  
  
  METHODS
  A review of patients with anal fistulae treated using Cook Surgisis AFP between October 2005 and 2007 was undertaken. Patient's demographics, fistulae aetiology and success rates were recorded.
  
  
  RESULTS
  Thirty-three patients underwent 49 plug insertions. The median age was 44.4 years; 18 females. The fistulae aetiology was cryptoglandular in 61% and Crohn's disease in 39%. The median follow up 221.5 days (range 44-684). Twenty-one patients had previous failed surgery. Twenty-eight patients had draining setons in situ at time of plug placement. The overall success rate was 8/32 patients (25%). Two of the 22 Crohn's fistulae healed (9.1%) and 9/26(34.6%) cryptoglandular fistulae healed. The reasons for failure were sepsis in 87% and plug dislodgement in 13%. Significant predictor factors for improved outcome were African-Americans patients (P = 0.009), and presence of seton (P = 0.05).
  
  
  CONCLUSIONS
  Anal fistulae plug was associated with a lower success rate than previously reported. Septic complications were the main reason for failure.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: G
authors.initials: G
authors.lastname: El-Gazzaz
authors.forename: M
authors.initials: M
authors.lastname: Zutshi
authors.forename: T
authors.initials: T
authors.lastname: Hull
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000601:surgery*; D019233:Retreatment; D012189:Retrospective Studies; D013630:Tampons, Surgical / Q000009:adverse effects; D016896:Treatment Outcome