[Experience with a biological plug for biological in complex anal fistula]

Treatment of complex anal fistula is a surgical challenge because the risk of sphincter injury with the possibility of developing fecal incontinence. There are many techniques for the treatment of anal fistulas such as fistulotomy, fistulectomy, seton, endorectal advancement flap and fibrin glue, with different rates of recurrence and fecal incontinence. The biologic plug Surgisis® AFP it's being used since 2006 and produces the closure of the fistula in approximately 12 weeks, without surgery, by replacement of the fistulous tract by cells of the patient, apparently having advantages over other techniques.We retrospectively reviewed the results of 46 patients with complex anorectal fistula treated with the biological plug over a period of 4 years. Of these, 34 were men (73.9%) and 12 women, the mean age was 47.2 years. According the type of fistula, 41 were recurrent fistulas (89.1%) and 5 high transsphincteric fistulas (10.8%). Patients underwent surgery on average 2.2 times previously. The anal fistula plug was successful in 73.9% of cases with a median follow-up 29.8 months. Use of anal fistula plug Surgisis® AFP is a new alternative with acceptable results in terms of recurrence comparable to other techniques, but with no incontinence.