Anal fistula plug <i>vs</i> rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta‐analysis of studies with long‐term follow‐up

Lin, Huapeng; Zheng, Jin; Zhu, Yibin; Diao, Mengyuan; Hu, Wei

doi:10.1111/codi.14504

Cited by 31 publications

(17 citation statements)

References 78 publications

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“…Dear Editor, Treatment of a complex anal fistula (CAF) is challenging as it demands a fine balance between the need to completely eradicate the pathology of the fistula tract and the need to preserve anal continence. To this end, different sphincter-saving procedures have been described for the treatment of CAF, including ligation of the intersphincteric fistula tract, rectal advancement flap, anal fistula plug, video-assisted anal fistula treatment and fistula laser closure technique [1][2][3][4]. The use of a seton in CAF has been mainly employed for drainage of anorectal sepsis before definitive surgery.…”

Section: Supporting Informationmentioning

confidence: 99%

“…Dear Sir, The enhanced-view totally extraperitoneal (e-TEP) technique for laparoscopic repair of complex inguinal hernias, which was previously described by Daes, overcomes the limitations of the classical TEP technique [1,2]. Belyansky et al adapted this technique to retromuscular mesh implantation for ventral hernia repair, which is called the extended totally extraperitoneal Rives-Stoppa (e-TEP RS) technique [3].…”

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confidence: 99%

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External anal sphincter sparing seton after rerouting of the fistula tract – a video vignette

et al. 2020

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Section: Supporting Informationmentioning

confidence: 99%

mentioning

confidence: 99%

External anal sphincter sparing seton after rerouting of the fistula tract – a video vignette

et al. 2020

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“…Cutting seton is a key method to treat complex anal fistula, which can protect sphincter function to some extent; however, the anal incontinence rate is still up to 34%-63%, and the postoperative pain is severe [6]. The anal fistula plug (AFP), as a sphincter-preserving technique, is simple, minimally invasive, and with a short length of stay [7], but the role of AFP in the treatment of complex cryptoglandular anal fistula is still not well established [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Adipose-Derived Stem Cells Are an Efficient Treatment for Fistula-in-ano of Japanese Rabbit

Qin

Wang

Huang

et al. 2019

Stem Cells International

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Fistula-in-ano (FIA, anal fistula) treatment remains a surgical challenge for coloproctologists. Adipose tissue-derived stem cells (ADSCs) are a new frontier in the treatment of FIA. In this study, we established a FIA model of Japanese rabbit and evaluated the effect of four treatments on fistula healing: ADSC transplantation, acellular small intestinal submucosa (ASIS), noncutting seton, and PBS as negative control. High-throughput RNA sequencing was also performed to investigate the anal tissue (normal and ADSC treatment group) expression profile of mRNA. Our data showed that ADSC treatment had the shortest time to promote fistula healing compared to the other treatments, and fistula filled with new adipose tissue and muscle cells without scar. Gene Ontology (GO) analysis of RNA-seq data showed that the differential genes are enriched in system development and animal organ development. Taken together, our findings demonstrate that ADSCs rapidly promote fistula healing through differentiation, a promising stem cell therapy for FIA. The rabbit is an effective animal model for evaluating FIA therapeutic options.

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“…

flap, anal fistula plug, video-assisted anal fistula treatment and fistula laser closure technique [1][2][3][4].The use of a seton in CAF has been mainly employed for drainage of anorectal sepsis before definitive surgery. However, a seton has also been described in the literature as a definitive treatment for CAF [5].

…”

mentioning

confidence: 99%

“…flap, anal fistula plug, video-assisted anal fistula treatment and fistula laser closure technique [1][2][3][4].…”

mentioning

confidence: 99%

LigaSure haemorrhoidectomy – a technical guide – a video vignette

Callahan

Smart

2020

Colorectal Disease

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flap, anal fistula plug, video-assisted anal fistula treatment and fistula laser closure technique [1-4]. The use of a seton in CAF has been mainly employed for drainage of anorectal sepsis before definitive surgery. However, a seton has also been described in the literature as a definitive treatment for CAF [5]. Rerouting of the seton and fistula tract has been devised to improve drainage and accelerate healing of the anal fistula. In a previous randomized trial [6] we compared the conventional drainage seton with a rerouting seton around the internal anal sphincter (IAS), sparing the external anal sphincter (EAS). The rerouting technique achieved quicker healing and less postoperative pain with a similar recurrence rate to the conventional drainage seton. In this report (Video S1) we describe the operative steps of rerouting a seton around the IAS, sparing the EAS. The procedure started with injection of hydrogen peroxide in the external opening; however, we were not able to locate the internal opening. Thus, excision of the superficial part of the fistula tract was undertaken, starting by coring out the external fistula opening and proceeding to dissect the fistula tract out. After dissection of the superficial part of the tract, a malleable metallic probe was inserted inside the tract and was guided gently to exit from the internal opening. A silk 0 suture was attached to the end of the probe and then the probe was withdrawn so that the silk seton was placed inside the fistula tract, encompassing both the IAS and EAS. An incision was made in the intersphincteric groove and dissection with artery forceps was done until the tip of the forceps came out through the intersphincteric plane. Then, the end of the silk seton was grasped with the forceps and withdrawn through the intersphincteric plane so that the silk seton was encircling the IAS only. The defect in the EAS was closed with interrupted polyglactin 2/0 sutures on a round body needle. The internal opening of the fistula was fulgurated with electrocautery; then the silk seton was tied around the IAS and left in place until it spontaneously dropped out.

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Anal fistula plug vs rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta‐analysis of studies with long‐term follow‐up

Cited by 31 publications

References 78 publications

External anal sphincter sparing seton after rerouting of the fistula tract – a video vignette

External anal sphincter sparing seton after rerouting of the fistula tract – a video vignette

Adipose-Derived Stem Cells Are an Efficient Treatment for Fistula-in-ano of Japanese Rabbit

LigaSure haemorrhoidectomy – a technical guide – a video vignette

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