Treatment of fistula-in-ano with the Surgisis ® AFP TM anal fistula plug

Abstract

Closure of the fistula tract with an anal fistula plug has been reported to provide success rates as high as 80%. The purpose of this study was to evaluate our results with this new method. From June 2006 to September 2007, an anal fistula plug was used for the treatment of high transsphincteric fistulas. Success was defined as no residual leakage or abscess formation and closure of the external opening. Fifteen patients (seven women), median age 46 years (range 32-58 years), were included in the study. Three had Crohn's disease, three had an anovulvar fistula and seven had undergone previous surgical-repair attempts. Three patients expelled the prosthesis on postoperative day 2, 5 and 7, respectively, and a second plug placement was followed by expulsion again. One patient developed an abscess that was noted on postoperative day 4. The fistula tract healed in 6/15 patients (40%) after 3 months and in 8/15 (53.3%) after 7 months. The success rate in Crohn's disease was 33%. No significant difference was found between patients with or without previous surgical repair. In our experience, this simple technique provided success rates of 40% at 3 months and 53% at 7 months.