Long-Term Results and Quality-of-Life Outcomes in Patients With Transsphincteric Fistulas After Muscle-Filling Procedure

Wang, Dong; Yamana, Tetsuo; Iwadare, J.

doi:10.1007/s10350-004-6352-4

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…A similar discrepancy between clinical outcomes and patient satisfaction had been found previously after the surgical treatment of fistula-in-ano [5,13]. In a retrospective analysis done by Wong et al, a group of patients surgically treated for fistula-in-ano nominated independent activity, pain, continence, psychological health and leakage as the five most important factors that affected their QOL.…”

Section: Discussionmentioning

confidence: 84%

Quality of life following surgery for recurrent fistula-in-ano

2009

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Section: Discussionmentioning

confidence: 84%

Quality of life following surgery for recurrent fistula-in-ano

2009

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“…The MAF is associated with a higher morbidity and significant risk of worsening incontinence (0%-52%) [36][37][38][39] . The AFP is associated with less damage.…”

Section: Discussionmentioning

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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“…The success rate of an advancement flap in different studies ranges from 37% to 100% [3,11–13,29] and of fibrin glue from 14% to 78% [7–10]. As an advancement flap is associated with a higher morbidity and significant risk of worsening continence or incontinence (0–52%) [3,11–13], perhaps it should be reserved as the back‐up option to be used after the minimally invasive methods have failed. As the data available is not sufficient, either of fibrin glue or AFP, depending on surgeon and patient’s preference, could be used as the first line management in complex fistulae‐in‐ano.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrin glue is a minimally invasive method associated with very little morbidity but has reported to have high rates of recurrence [7–10]. Therefore, advancement flap is the preferred method for the treatment of complex fistulas; however, it is also associated with significant morbidity and risk of incontinence [3,11–13].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of anal fistula plug in fistula‐in‐ano: a systematic review

et al. 2009

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Anal fistula plug procedure has a success rate ranging from 24% to 92% in different studies. In prospective studies of complex fistula-in-ano, there was a moderate success rate of 35-87%. As AFP is associated with low morbidity and sepsis, it appears to be a safe procedure. Further randomized controlled trials studying objective parameters of fistula healing are needed to substantiate these findings.

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Long-Term Results and Quality-of-Life Outcomes in Patients With Transsphincteric Fistulas After Muscle-Filling Procedure

Abstract: The muscle-filling procedure is a viable option in the treatment of transsphincteric fistulas, with a favorable recurrence rate and an overall patient satisfaction rate above 88 percent.

Cited by 10 publications

References 18 publications

Quality of life following surgery for recurrent fistula-in-ano

Quality of life following surgery for recurrent fistula-in-ano

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

The efficacy of anal fistula plug in fistula‐in‐ano: a systematic review

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