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

被引：81
作者：
Garg, P. [1 ,2 ]
Song, J. [3 ]
Bhatia, A. [4 ]
Kalia, H. [5 ]
Menon, G. R. [6 ]
机构：
[1] Fortis Super Specialty Hosp, Dept Gen Surg, Mohali, Punjab, India
[2] MM Inst Med Sci & Res, Dept Gen Surg, Mullana, Haryana, India
[3] Univ Calif Irvine, Coll Med, Irvine, CA 92717 USA
[4] Natl Inst Pharmaceut Educ & Res, Dept Stat, Mohali, India
[5] Univ Rochester, Dept Radiol, Rochester, NY 14627 USA
[6] Indian Council Med Res, Dept Stat, New Delhi, India
来源：
COLORECTAL DISEASE | 2010年 / 12卷 / 10期
关键词：
Fistula-in-ano; anal fistula plug; review; recurrence; complex; ENDORECTAL ADVANCEMENT FLAP; FIBRIN GLUE; ANORECTAL FISTULAS; TRANSSPHINCTERIC FISTULAS; INITIAL-EXPERIENCE; CLOSURE; REPAIR; ADHESIVE; SEALANT;
D O I：
10.1111/j.1463-1318.2009.01933.x
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
Aims To assess the efficacy of anal fistula plug (AFP) procedure for the treatment of fistula-in-ano especially the complex fistulas. Method The database of PUBMED, MEDLINE, SCOPUS, EMBASE and COCHRANE LIBRARY for the period 1995-2009 was searched. A systematic analysis was carried to evaluate the success rate of AFP procedure in fistula-in-ano. Results A total of 25 studies were extracted and 12 (n = 317) were finally included in the systematic review. The follow-up period ranged from 3.5 to 12 months. The AFP procedure had a success rate (patient cure rate) ranging from 24% to 92%. In complex fistula-in-ano in prospective studies (8/12 studies), the success rate was 35-87%. The success rate in patients with Crohn's disease was 29-86%. The success rate in the patients with single tracts was 44-93% and in patients with multiple tracts, success ranged from 20% to 71%. The abscess formation/sepsis rate was 4-29% (11/108) and the plug extrusion rate was 4-41% (42/232-19%). Conclusion 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.
引用
收藏
页码：965 / 970
页数：6
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