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Erschienen in: Diseases of the Colon & Rectum 12/2006

01.12.2006 | Original Contributions

Efficacy of Anal Fistula Plug in Closure of Cryptoglandular Fistulas: Long-Term Follow-Up

verfasst von: Bradley J. Champagne, M.D., Lynn M. O’Connor, M.D., Martha Ferguson, M.D., Guy R. Orangio, M.D., Marion E. Schertzer, M.D., David N. Armstrong, M.D., F.R.C.S.

Erschienen in: Diseases of the Colon & Rectum | Ausgabe 12/2006

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Abstract

Purpose

The long-term efficacy of Surgisis® anal fistula plug in closure of cryptoglandular anorectal fistulas was studied.

Methods

Patients with high cryptoglandular anorectal fistulas were prospectively studied. Additional variables recorded were: number of fistula tracts, and presence of setons. Under general anesthesia and in prone jackknife position, patients underwent irrigation of the fistula tract by using hydrogen peroxide. Each primary opening was occluded by using a Surgisis® anal fistula plug, which was securely sutured in place at the primary opening and tacked to the periphery of the secondary opening.

Results

Forty-six patients were prospectively enrolled during a two-year period. Follow-up was six months to two years (median, 12 months). At final follow-up, all fistula tracts had been successfully closed in 38 patients, for an overall success rate of 83 percent. Seven patients had multiple tracts, for a total of 55 fistula tracts in the series. Of the 55 individual tracts, 47 (85 percent) were closed at final follow-up. Patients with one primary opening were most likely to have successful closure by using the anal fistula plug, although this was not significant. Successful closure was not correlated with the presence of setons.

Conclusions

Long-term closure of cryptoglandular anorectal fistula tracts using Surgisis® anal fistula plug is safe and successful in 83 percent of patients and 85 percent of tracts.
Literatur
1.
Zurück zum Zitat Johnson, E, Gaw, JU, Armstrong, DN 2006Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulaDis Colon Rectum49371376PubMedCrossRef Johnson, E, Gaw, JU, Armstrong, DN 2006Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulaDis Colon Rectum49371376PubMedCrossRef
2.
Zurück zum Zitat Buchanan, GN, Bartram, CI, Phillips, RK, et al. 2003Efficacy of fibrin sealant in the management of complex anal fistulasDis Colon Rectum4611671174PubMedCrossRef Buchanan, GN, Bartram, CI, Phillips, RK,  et al. 2003Efficacy of fibrin sealant in the management of complex anal fistulasDis Colon Rectum4611671174PubMedCrossRef
3.
Zurück zum Zitat Sentovic, SM 2003Fibrin glue for anal fistulasDis Colon Rectum46498502CrossRef Sentovic, SM 2003Fibrin glue for anal fistulasDis Colon Rectum46498502CrossRef
4.
Zurück zum Zitat Lindsey, I, Smilgin-Humphreys, MM, Cunningham, C, Mortensen, NJ, George, B 2002A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistulaDis Colon Rectum4516081615PubMedCrossRef Lindsey, I, Smilgin-Humphreys, MM, Cunningham, C, Mortensen, NJ, George, B 2002A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistulaDis Colon Rectum4516081615PubMedCrossRef
5.
Zurück zum Zitat Singer, M, Cintron, J, Nelson, R, et al. 2005Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or closure of the internal fistula openingDis Colon Rectum48799808PubMedCrossRef Singer, M, Cintron, J, Nelson, R,  et al. 2005Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or closure of the internal fistula openingDis Colon Rectum48799808PubMedCrossRef
6.
Zurück zum Zitat Cintron, J, Park, JJ, Orsay, CP, et al. 2000Repair of fistulas-in-ano using fibrin adhesive: long-term follow-upDis Colon Rectum43944949PubMedCrossRef Cintron, J, Park, JJ, Orsay, CP,  et al. 2000Repair of fistulas-in-ano using fibrin adhesive: long-term follow-upDis Colon Rectum43944949PubMedCrossRef
7.
Zurück zum Zitat Badylak, SF 2002The extra cellular matrix as a scaffold for tissue reconstructionSemin Cell Dev Biol13377383PubMedCrossRef Badylak, SF 2002The extra cellular matrix as a scaffold for tissue reconstructionSemin Cell Dev Biol13377383PubMedCrossRef
8.
Zurück zum Zitat Badylak, SF 1993Small intestinal submucosa (SIS): a biomaterial conducive to smart tissue remodelingBell, E eds. Tissue engineering: current perspectivesBurkhauser PublishersCambridge179189 Badylak, SF 1993Small intestinal submucosa (SIS): a biomaterial conducive to smart tissue remodelingBell, E eds. Tissue engineering: current perspectivesBurkhauser PublishersCambridge179189
9.
Zurück zum Zitat Garcia-Aguilar, J, Davey, CS, Le, CT, Lowry, AC, Rothenberger, DA 2000Patient satisfaction after surgical treatment for fistula-in-anoDis Colon Rectum4312061212PubMedCrossRef Garcia-Aguilar, J, Davey, CS, Le, CT, Lowry, AC, Rothenberger, DA 2000Patient satisfaction after surgical treatment for fistula-in-anoDis Colon Rectum4312061212PubMedCrossRef
10.
Zurück zum Zitat Zimmermann, DD, Briel, JW, Gosselink, MP, Schouten, WR 2001Anocutaneous advancement flap repair of transsphincteric fistulasDis Colon Rectum4414741480CrossRef Zimmermann, DD, Briel, JW, Gosselink, MP, Schouten, WR 2001Anocutaneous advancement flap repair of transsphincteric fistulasDis Colon Rectum4414741480CrossRef
11.
Zurück zum Zitat Sonoda, T, Hull, T, Piedmonte, MR, Fazio, VW 2002Outcomes of primary repair of anorectal and rectovaginal fistulas using endorectal advancement flapDis Colon Rectum4516221628PubMedCrossRef Sonoda, T, Hull, T, Piedmonte, MR, Fazio, VW 2002Outcomes of primary repair of anorectal and rectovaginal fistulas using endorectal advancement flapDis Colon Rectum4516221628PubMedCrossRef
12.
Zurück zum Zitat Schouten, WR, Zimmermann, DD, Briel, JW 1999Transanal advancement flap repair of transsphincteric fistulaDis Colon Rectum4214191423PubMedCrossRef Schouten, WR, Zimmermann, DD, Briel, JW 1999Transanal advancement flap repair of transsphincteric fistulaDis Colon Rectum4214191423PubMedCrossRef
13.
Zurück zum Zitat Mizrahi, NM, Wexner, SD, Zmora, O 2002Endorectal advancement flap. Are there predictors of failure?Dis Colon Rectum4516161621PubMedCrossRef Mizrahi, NM, Wexner, SD, Zmora, O 2002Endorectal advancement flap. Are there predictors of failure?Dis Colon Rectum4516161621PubMedCrossRef
14.
Zurück zum Zitat Tsang, CB, Madoff, RD, Wong, WD, et al. 1998Anal sphincter integrity and function influences outcome in rectovaginal fistula repairDis Colon Rectum4111411146PubMedCrossRef Tsang, CB, Madoff, RD, Wong, WD,  et al. 1998Anal sphincter integrity and function influences outcome in rectovaginal fistula repairDis Colon Rectum4111411146PubMedCrossRef
15.
Zurück zum Zitat Schouten, WR, Zimmermann, DD, Briel, HD 1999Transanal advancement flap repair of transsphincteric fistulasDis Colon Rectum4214191423PubMedCrossRef Schouten, WR, Zimmermann, DD, Briel, HD 1999Transanal advancement flap repair of transsphincteric fistulasDis Colon Rectum4214191423PubMedCrossRef
16.
Zurück zum Zitat Ueno, T, Pickett, LC, Feunte, SG, Lawson, DC, Pappas, TN 2004Clinical applications of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defectsJ Gastrointest Surg8109112PubMedCrossRef Ueno, T, Pickett, LC, Feunte, SG, Lawson, DC, Pappas, TN 2004Clinical applications of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defectsJ Gastrointest Surg8109112PubMedCrossRef
17.
Zurück zum Zitat Franklin, ME, Gonzalez, JJ, Glass, JL 2004Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2 year follow-upHernia8186189PubMed Franklin, ME, Gonzalez, JJ, Glass, JL 2004Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2 year follow-upHernia8186189PubMed
18.
Zurück zum Zitat Helton, WS, Fisichella, PM, Berger, R, et al. 2005Short-term outcomes with small intestinal submucosa for ventral abdominal herniaArch Surg140549562PubMedCrossRef Helton, WS, Fisichella, PM, Berger, R,  et al. 2005Short-term outcomes with small intestinal submucosa for ventral abdominal herniaArch Surg140549562PubMedCrossRef
Metadaten
Titel
Efficacy of Anal Fistula Plug in Closure of Cryptoglandular Fistulas: Long-Term Follow-Up
verfasst von
Bradley J. Champagne, M.D.
Lynn M. O’Connor, M.D.
Martha Ferguson, M.D.
Guy R. Orangio, M.D.
Marion E. Schertzer, M.D.
David N. Armstrong, M.D., F.R.C.S.
Publikationsdatum
01.12.2006
Erschienen in
Diseases of the Colon & Rectum / Ausgabe 12/2006
Print ISSN: 0012-3706
Elektronische ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-006-0755-3

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