Early experience with the bioabsorbable anal fistula plug
D A Lawes1, J E Efron, M Abbas
1Division of Colorectal Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA. dannylawes@hotmail.com
World Journal of Surgery
|April 1, 2008
Summary
The Surgisis anal fistula plug showed low healing rates and high sepsis incidence in this study. Combining the plug with an anal advancement flap may improve outcomes for anal fistula treatment.
Area of Science:
- Colorectal Surgery
- Gastroenterology
Background:
- Anal fistula management requires balancing cure rates with anal continence preservation.
- Previous reports suggested high healing rates for the porcine anal fistula plug with minimal complications.
Purpose of the Study:
- To evaluate the outcomes of anal fistula treatment using the Surgisis anal plug.
- To assess the efficacy and safety of the Surgisis anal plug in a patient cohort.
Main Methods:
- Retrospective review of patients treated for anal fistula with the Surgisis anal plug.
- Analysis of fistula healing rates, complications, and previous treatment history.
Main Results:
- Only 24% of patients treated with the plug alone achieved fistula closure.
- A high incidence of postoperative sepsis (29%) was observed in patients treated with the plug alone.
- Two patients treated with the plug and an anal advancement flap achieved successful healing.
Conclusions:
- The Surgisis anal plug demonstrated a low fistula healing rate and a high incidence of perianal sepsis in this series.
- Concomitant use of a transanal advancement flap may enhance success rates for anal fistula treatment with the plug.
