title: Efficacy of an anal fistula plug for fistulas-in-Ano in children.
abstract: BACKGROUND
  In children, perianal abscesses have a good prognosis and often heal with age. However, some perianal abscesses are refractory to treatment and remain as fistulas-in-Ano. Treatment with a Surgisis Anal Fistula Plug® has been reported as a new method of treatment for fistulas. In adults, the plug has been reported to cause little pain and have a high cure rate, but there have been no reported cases of its use in children.
  
  
  OBJECTIVE
  This study was designed to analyze the efficacy of the plug for closure of refractory fistulas in children.
  
  
  METHODS
  Since the plug has not been approved as a medical device in Japan, application for its use was submitted to the ethics committee of our university, and approval was granted, marking the first use of the plug in Japan. We classified refractory fistulas as those treated for 6months or longer and remaining unhealed, even after 1year of age, despite continued conservative treatment. The plug was used in 11 refractory fistulas in 8 children.
  
  
  RESULTS
  Eight of 11 fistulas (72.7%) were successfully treated. Three fistulas recurred, and fistulectomies were performed. No sequelae were observed after AFP treatment.
  
  
  CONCLUSIONS
  The plug was effective even for closure of refractory fistulas without sequelae in children.
  
  
  METHODS
  Treatment Study, Level IV.
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan. Electronic address: kouchi@tymc.twmu.ac.jp.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kouchi
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan.
authors.forename: Ayao
authors.initials: A
authors.lastname: Takenouchi
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Matsuoka
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan.
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Yabe
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan.
authors.forename: Mashahiro
authors.initials: M
authors.lastname: Korai
authors.affiliation: Department of Pediatric Surgery, Tokyo Women's University Yachiyo Medical Center, 477-96 Ohwada-Shinden, Yachiyo City, Chiba 276-8524, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Nakata
mesh_terms: D000038:Abscess / Q000150:complications; D001004:Anus Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003094:Collagen; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012003:Rectal Fistula / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D013630:Tampons, Surgical; D016896:Treatment Outcome
chemical_list: C588278:surgisis; D003094:Collagen
keywords: Children; Cryptoglandular fistulas; Perianal abscess