Document Detail


Early experience with the bioabsorbable anal fistula plug.
MedLine Citation:
PMID:  18373120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS: The outcome of patients who underwent treatment for anal fistula with the Surgisis anal plug was retrospectively reviewed. RESULTS: Twenty patients were treated; three underwent concomitant anal advancement flap at the time of plug placement. Seventeen patients had a trans-sphincteric fistula, and three had an anoperineal fistula. Ten patients had previously undergone failed surgical therapy to cure their fistula, including anal advancement flap in four, muscle interposition flap in two, fistulotomy in two, and cutting seton placement in two. Mean follow-up was 7.4 months. Only 4 of 17 (24%) patients treated with the plug alone had closure of their fistula. Acute postoperative sepsis was seen in 5 of 17 (29%) patients treated with the plug alone. Four developed perianal abscesses that required incision and drainage, and one intersphincteric abscess was treated with antibiotics. Two of the patients who underwent concomitant anal advancement flaps and plug placement healed successfully. CONCLUSIONS: Contrary to other published series, the use of the Surgisis anal plug was associated with a low rate of fistula healing and a high incidence of perianal sepsis. The addition of a transanal advancement flap to the procedure may improve success rates.
Authors:
D A Lawes; J E Efron; M Abbas; J Heppell; T M Young-Fadok
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1157-9     Citation Subset:  IM    
Affiliation:
Division of Colorectal Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA. dannylawes@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Female
Humans
Male
Middle Aged
Rectal Fistula / surgery*
Retrospective Studies
Surgical Flaps

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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