Efficacy of Anal Fistula Plug vs. Fibrin Glue in Closure of Anorectal Fistulas

Johnson, Eric K.; Gaw, Janette U.; Armstrong, David N.

doi:10.1007/s10350-005-0288-1

Cited by 293 publications

(211 citation statements)

References 14 publications

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“…Johnson et al [13] first described the anal fistula plug (AFP) in 2006; the plug is made of lyophilized porcine intestinal submucosa. Since then, several studies on the AFP have been reported with variable results.…”

Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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AIM:To investigate the efficacy of the anal fistula plug (AFP) compared to the mucosa advancement flap (MAF), considered the best procedure for patients with a complex anal fistula. METHODS:The literature search included PubMed, EMBASE, Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011. Randomized controlled trials, controlled clinical trials and prospective cohort studies were included in the review. After information collection, a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity. The quality of postoperative life was also included with the clinical results. RESULTS:Six studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 -0.14; RD = 0.13; 95%CI: -0.18 -0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 --0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 --0.00). The postoperative quality of life, for patients treated using the AFP was superior to that of the MAF patients. Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced. CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula; it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life. Additional evidence is needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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“…The results of fibrin glue treatment have been disappointing and the technique has largely been abandoned [12]. Furthermore, treatment is changing, the introduction of the fistula plug has had initial satisfactory results [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Incontinence rates after cutting seton treatment for anal fistula

2009

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Objective To determine the incidence of anal incontinence after the use of cutting seton treatment for anal fistula.Method Literature searches were performed on PubMed, MEDLINE and Google Ô Scholar using the words 'cutting seton(s)', 'seton(s)' and 'anal fistula'. An analysis of the data in the collected references was performed.Results The average rate of incontinence following cutting seton use was 12%. The rate of incontinence increased as the location of the internal opening of the fistula moved more proximally. In the studies that described the types of incontinence, liquid stool was the most common followed closely by flatus incontinence. Incontinence associated with the treatment of fistulas defined as nonspecific cryptoglandular in nature was 18%.Conclusion The high incontinence rates that result from the use of cutting setons suggest that this commonly used therapy can damage the continence musculature. Other techniques that do not involve cutting the sphincter, when available, should be preferred, especially for higher fistulas.

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“…110,111 Surgisis is an acellular biomaterial matrix obtained from porcine small intestinal submucosa which can stimulate fistula closure without inducing inflammatory response. 112 Toussaint et al 113 were the first to successfully use Surgisis AFP to close fistula associated with bariatric surgery.…”

Section: Novel Endoluminal Optionsmentioning

confidence: 99%

Endoscopic management of postoperative fistulas and leaks

Devaraj

Gavini

2017

Int J Gastrointest Interv

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Postoperative complications from gastrointestinal surgery can be associated with significant morbidity, and mortality especially if repeat surgery is needed to address these complications. There are wide array of endoscopic interventions and tools available for management of these complications using minimally invasive methods thus decreasing length of hospitalization, morbidity and leading to better patient outcomes. With the advent new tools like Overstitch device, Over the Scope Clip, fibrin glue, etc., these complications can be managed successfully with minimal morbidity. We provide an indepth discussion about available endoscopic options and their application in various scenarios in our article. Endoscopist should be familiar with these complications and endoscopic tools to promote use of these tools and techniques to achieve successful management of these complex conditions.

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Efficacy of Anal Fistula Plug vs. Fibrin Glue in Closure of Anorectal Fistulas

Cited by 293 publications

References 14 publications

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Incontinence rates after cutting seton treatment for anal fistula

Endoscopic management of postoperative fistulas and leaks

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