Efficacy of an anal fistula plug for fistulas-in-Ano in children

Background: In children, perianal abscesses have a good prognosis and often heal with age. However, some perianal abscesses are refractory to treatment and remain as fistulas-in-Ano. Treatment with a Surgisis Anal Fistula Plug (R) has been reported as a new method of treatment for fistulas. In adults, the plug has been reported to cause little pain and have a high cure rate, but there have been no reported cases of its use in children. Purpose: This study was designed to analyze the efficacy of the plug for closure of refractory fistulas in children. Methods: Since the plug has not been approved as a medical device in Japan, application for its use was submitted to the ethics committee of our university, and approval was granted, marking the first use of the plug in Japan. We classified refractory fistulas as those treated for 6 months or longer and remaining unhealed, even after 1 year of age, despite continued conservative treatment. The plug was used in 11 refractory fistulas in 8 children. Results: Eight of 11 fistulas (72.7%) were successfully treated. Three fistulas recurred, and fistulectomies were performed. No sequelae were observed after AFP treatment. Conclusion: The plug was effective even for closure of refractory fistulas without sequelae in children. (C) 2017 Elsevier Inc. All rights reserved.