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. 2023 May;25(5):995-1001.
doi: 10.1111/codi.16501. Epub 2023 Feb 21.

Improved fistula plug outcome depends on the type of plug: a single-centre retrospective study

Adele E Sayers  1 , Matthew J Lee  2   3 , Steve R Brown  2   3
Affiliations

Improved fistula plug outcome depends on the type of plug: a single-centre retrospective study

Adele E Sayers et al. Colorectal Dis. 2023 May.

Abstract

Aim: Fistula-in-ano is a common condition that is potentially difficult to treat. In recent years 'sphincter-sparing' procedures have increased in popularity due to the lower rates of reported complications, such as incontinence. One such treatment is the fistula plug, which has seen varied success compared with other techniques. There are currently several plugs on the market and it is possible that difference in outcomes could be linked to the type of plug used. The aim of this study was to compare healing and complication rates between two fistula plugs in a single tertiary referral centre in the UK.

Method: We conducted a single-centre retrospective analysis of all patients over the age of 18 years who underwent elective fistula plug insertion, with two different fistula plugs over a 13-year period.

Results: A total of 113 patients underwent fistula plug insertion (plug A n = 90; plug B n = 23). Plug B had been on the market for the final 4 years of the study period, hence the differing patient numbers. There was no difference in patient demographics, fistula type or aetiology of the fistula between the two plugs. Plug B had a significantly higher fistula healing rate compared with plug A (56.5% vs. 12.2%; p < 0.005). A quarter of all patients experienced a complication, 93% being those who had fistula plug A inserted. The most common complication was extrusion of the plug within 72 h of insertion.

Conclusion: This study demonstrated significantly different outcomes according to the type of fistula plug used. Whilst current randomized controlled trials have not found a significant difference in healing rates when comparing one type of fistula plug to other treatment modalities, this study suggests that plug type may influence efficacy.

Keywords: cohort; fistula; fistula plug.

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References

REFERENCES

    1. Hansen MS, Kjaer ML, Andersen J. Efficacy of plug treatment for complex anorectal fistulae: long-term Danish results. Ann Coloproctol. 2019;35:123-8.
    1. Aho Fält U, Zawadzki A, Starck M, Bohe M, Johnson LB. Long-term outcome of the Surgisis® (biodesign®) anal fistula plug for complex cryptoglandular and Crohn's fistulas. Colorectal Dis. 2021;23(1):178-85.
    1. Kontovounisios C, Tekkis P, Tan E, Rasheed S, Darzi A, Wexner SD. Adoption and success rates of perineal procedures for fistula-in-ano: a systematic review. Colorectal Dis. 2016;18(5):441-58.
    1. Owen HA, Buchanan GN, Schizas A, Cohen R, Williams AB. Quality of life with anal fistula. Ann R Coll Surg Engl. 2016;98(5):334-8.
    1. Sarzo G, Finco C, Mungo B, Gruppo M, Cadrobbi R, Polese L, et al. Anal fistula repair with acellular dermal matrix plug: description of a novel technique and early results. J Surg. 2013;1:6.

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