CR36P TREATMENT OF ANAL FISTULA WITH THE COLLAGEN FISTULA PLUG

Abstract

Purpose: We investigated the use of ‘Surgisis’ anorectal fistula plug in the treatment of anorectal fistula. Success rates quoted have been variable. There is no known data regarding when to reattempt the ‘Surgisis’ plug if failure occurs. We assessed our success rate and looked at any pattern for reinsertion of the ‘Surgisis’ anorectal plug.Methodology: We retrospectively collected patient/fistula characteristics, procedure details, and follow‐up information for all patients treated with the anal fistula plug at our institution over the past 5 years. The outcome was considered successful if the external and internal opening were closed and if the patient had no drainage at the last follow‐up.Results: Of 16 patients, 21 fistulae were treated with the ‘Surgisis’ anorectal fistula plug. 28.5% had complete healing after the first attempt at insertion of the ‘Surgisis’ plug, while 28.5% required a reinsertion of the ‘Surgisis’ plug for complete healing to occur. 43% failed to heal with the insertion of the ‘Surgisis’ plug or were awaiting follow‐up. The period of time between insertion of seton, subsequent failure and insertion of ‘Surgisis’ plug was extremely variable. Median time taken was 220 (41–553) days. Following this the median time taken for reinsertion was 303 (151–495) days.Conclusion: Collectively our success rate for ‘Surgisis’ plug insertion is 57% however only 28.5% after first insertion. There is no clear relationship between the time period and the success of reinsertion of the ‘Surgisis’ plug. More data is required to give clear guidelines for timing of ‘Surgisis’ plug reinsertion.