title: Fistula plug versus conventional surgical treatment for anal fistulas.  A system review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the recurrence and fecal incontinence of anal fistula plug versus conventional surgical treatment for anal fistulas.
  
  
  METHODS
  This meta-analysis was carried out in the General Surgery Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. We searched the Medline, EMBASE, and Cochrane Library from June 2011 to April 2012. The literature searches were carried out using medical subject headings and free-text word: anal fistula, fibrin adhesive, fibrin sealant, and fistula plug.
  
  
  RESULTS
  Two randomized controlled trials and 3 retrospective controlled studies were included. A total of 428 patients were included in our study. The recurrence rate was higher in those patients who accept fistula plug treatment (62.1% versus 47%) (p=0.004).
  
  
  CONCLUSIONS
  Anal fistula plug has a moderate probability of success with little risk of incontinence, but the recurrence rate is significantly higher than the conventional surgical treatment. This treatment is minimally invasive, repeatable, and sphincter-sparing. This meta-analysis failed to find a statistically significant difference in incontinence rate between conservative treatment and conventional surgical treatment.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, China.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Pu
authors.forename: Chun-Gen
authors.initials: CG
authors.lastname: Xing
authors.forename: Imran
authors.initials: I
authors.lastname: Khan
authors.forename: Kui
authors.initials: K
authors.lastname: Zhao
authors.forename: Bao-Song
authors.initials: BS
authors.lastname: Zhu
authors.forename: Yong
authors.initials: Y
authors.lastname: Wu
mesh_terms: D002681:China; D005242:Fecal Incontinence / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D012003:Rectal Fistula / Q000534:rehabilitation* / Q000601:surgery / Q000628:therapy