Long-Term Outcomes With the Use of Bioprosthetic Plugs for the Management of Complex Anal Fistulas
- 1 May 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Diseases of the Colon & Rectum
- Vol. 53 (5), 798-802
- https://doi.org/10.1007/dcr.0b013e3181d43b7d
Abstract
This study was undertaken to determine the long-term outcomes of patients whose anal fistulas were managed by use of bioprosthetic plugs. A retrospective analysis was performed of all patients whose anal fistula was managed by use of a bioprosthetic plug between May 2005 and September 2006, who had a minimum of 1 year of follow-up since their last treatment. Patients whose fistulas were clinically healed were offered MRI to confirm healing of the fistula. The bioprosthetic fistula plug was used to treat an anal fistula in 63 patients with clinical healing of the fistula in 51 (81%). Multivariate analysis showed that tobacco smoking, posterior fistula, and history of previous failure of the bioprosthetic plug was predictive of failure of the bioprosthetic plug. Eight patients with clinical healing after a minimum of 1 year since their last treatment underwent MRI. No evidence of residual fistula tract or fluid in the area of the previous fistula was found in 6 (75%) of these patients. Bioprosthetic plugs are effective for the long-term closure of complex fistulas-in-ano. Randomized clinical trials comparing bioprosthetic plugs with other sphincter-preserving methods for fistula management need to be conducted to further determine the role of bioprosthetics in the management of anal fistulas.Keywords
This publication has 28 references indexed in Scilit:
- Treatment of Transsphincteric Anal Fistulas by Endorectal Advancement Flap or Collagen Fistula PlugDiseases of the Colon & Rectum, 2009
- Anal Fistula Plug for Closure of Difficult Anorectal Fistula: A Prospective StudyDiseases of the Colon & Rectum, 2007
- Successful Sphincter-Sparing Surgery for All Anal FistulasDiseases of the Colon & Rectum, 2007
- Smoking affects the outcome of transanal mucosal advancement flap repair of trans-sphincteric fistulasBritish Journal of Surgery, 2003
- Fibrin glue for all anal fistulasJournal of Gastrointestinal Surgery, 2001
- Cutting seton for anal fistulasDiseases of the Colon & Rectum, 1997
- Continence disorders after anal fistulotomyDiseases of the Colon & Rectum, 1994
- The incidence of recurrent abscesses or fistula-in-ano following anorectal suppurationDiseases of the Colon & Rectum, 1984
- The treatment of high fistula-in-anoDiseases of the Colon & Rectum, 1976
- Fistula-in-AnoDiseases of the Colon & Rectum, 1976