Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2009
To determine the efficacy of anal fistula plug in the treatment of high fistula-in-ano: an initial experience.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Garg P
Аннотация
OBJECTIVE: The aim of this study was to determine the efficacy of the anal fistula plug in the treatment of high fistula-in-ano.
METHOD: Twenty-three patients with high cryptoglandular fistula-in-ano were prospectively studied over 1 year. The number of tracks, number of previous procedures and co-morbid conditions that could potentially affect outcome were noted. A seton was used to guide the AFP into the fistula track which was anchored at the primary opening.
RESULTS: Two patients were lost to follow-up. Twenty-one patients (mean age was 49.8 years) were followed from 192 to 543 days (median = 292 days). Thirteen patients had single track, eight had multiple tracks and 14 had a recurrent fistula. Success, defined by closure of all fistula tracks occurred in 71.4% (15/21). The success rate was 84.6% in patients with a single fistula track (11/13) compared with 50% in patients with multiple tracks (4/8) (P = 0.14, Fisher's exact test). Recurrent [10/14 (71.4%)] vs nonrecurrent fistulae [5/7 (71.4%)] had no bearing on the outcome (P = 1.0). Two patients experienced healing despite extrusion of the plug in the early postoperative period. The procedure was safe and well tolerated.
CONCLUSION: The Surgisis AFP was successful in 71.4% of patients. Plug extrusion does not necessarily mean failure.
METHOD: Twenty-three patients with high cryptoglandular fistula-in-ano were prospectively studied over 1 year. The number of tracks, number of previous procedures and co-morbid conditions that could potentially affect outcome were noted. A seton was used to guide the AFP into the fistula track which was anchored at the primary opening.
RESULTS: Two patients were lost to follow-up. Twenty-one patients (mean age was 49.8 years) were followed from 192 to 543 days (median = 292 days). Thirteen patients had single track, eight had multiple tracks and 14 had a recurrent fistula. Success, defined by closure of all fistula tracks occurred in 71.4% (15/21). The success rate was 84.6% in patients with a single fistula track (11/13) compared with 50% in patients with multiple tracks (4/8) (P = 0.14, Fisher's exact test). Recurrent [10/14 (71.4%)] vs nonrecurrent fistulae [5/7 (71.4%)] had no bearing on the outcome (P = 1.0). Two patients experienced healing despite extrusion of the plug in the early postoperative period. The procedure was safe and well tolerated.
CONCLUSION: The Surgisis AFP was successful in 71.4% of patients. Plug extrusion does not necessarily mean failure.