Cargando…
Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas
BACKGROUND: An anal fistula plug is a sphincter-sparing procedure that uses biological substances to close an anorectal fistula. This study aimed to evaluate the long-term therapeutic effect of an anal fistula plug procedure in patients with trans-sphincteric fistula-in-ano and to determine the risk...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727077/ https://www.ncbi.nlm.nih.gov/pubmed/33279927 http://dx.doi.org/10.12659/MSM.928181 |
_version_ | 1783621025507835904 |
---|---|
author | Tao, Yu Zheng, Yi Han, Jia Gang Wang, Zhen Jun Cui, Jin Jie Zhao, Bao Cheng Yang, Xin Qing |
author_facet | Tao, Yu Zheng, Yi Han, Jia Gang Wang, Zhen Jun Cui, Jin Jie Zhao, Bao Cheng Yang, Xin Qing |
author_sort | Tao, Yu |
collection | PubMed |
description | BACKGROUND: An anal fistula plug is a sphincter-sparing procedure that uses biological substances to close an anorectal fistula. This study aimed to evaluate the long-term therapeutic effect of an anal fistula plug procedure in patients with trans-sphincteric fistula-in-ano and to determine the risk factors affecting fistula healing. MATERIAL/METHODS: A single-center retrospective study was performed assessing long-term treatment outcomes of patients with low trans-sphincteric anal fistulas who initially underwent anal fistula plug procedures between August 2008 and September 2012. Risk factors affecting fistula healing were identified using univariate and multivariate analyses. RESULTS: A total of 135 patients who had low trans-sphincteric anal fistulas and underwent anal fistula plug procedures were analysed. The overall healing rate was 56% (75/135) with a median follow-up time of 8 years (range, 72–121 months). The primary reasons for treatment failure were plug extrusion (n=12, 20%) and surgical site infection (n=9, 15%), occurring within 30 days after surgery. Multiple logistic regression analysis showed that the duration of anal fistula ≥6 months was significantly associated with treatment failure using an anal fistula plug (OR=3.187, 95% CI: 1.361–7.466, P=0.008). Of the patients who failed initial treatment with an anal fistula plug, 6 (9%) had anal fistulas that healed spontaneously after 2–3 years without additional treatment. CONCLUSIONS: As a sphincter-preserving procedure, the anal fistula plug can effectively promote healing of low trans-sphincteric anal fistulas. The long-term efficacy is good and the procedure warrants wider use in clinical practice. |
format | Online Article Text |
id | pubmed-7727077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77270772020-12-11 Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas Tao, Yu Zheng, Yi Han, Jia Gang Wang, Zhen Jun Cui, Jin Jie Zhao, Bao Cheng Yang, Xin Qing Med Sci Monit Clinical Research BACKGROUND: An anal fistula plug is a sphincter-sparing procedure that uses biological substances to close an anorectal fistula. This study aimed to evaluate the long-term therapeutic effect of an anal fistula plug procedure in patients with trans-sphincteric fistula-in-ano and to determine the risk factors affecting fistula healing. MATERIAL/METHODS: A single-center retrospective study was performed assessing long-term treatment outcomes of patients with low trans-sphincteric anal fistulas who initially underwent anal fistula plug procedures between August 2008 and September 2012. Risk factors affecting fistula healing were identified using univariate and multivariate analyses. RESULTS: A total of 135 patients who had low trans-sphincteric anal fistulas and underwent anal fistula plug procedures were analysed. The overall healing rate was 56% (75/135) with a median follow-up time of 8 years (range, 72–121 months). The primary reasons for treatment failure were plug extrusion (n=12, 20%) and surgical site infection (n=9, 15%), occurring within 30 days after surgery. Multiple logistic regression analysis showed that the duration of anal fistula ≥6 months was significantly associated with treatment failure using an anal fistula plug (OR=3.187, 95% CI: 1.361–7.466, P=0.008). Of the patients who failed initial treatment with an anal fistula plug, 6 (9%) had anal fistulas that healed spontaneously after 2–3 years without additional treatment. CONCLUSIONS: As a sphincter-preserving procedure, the anal fistula plug can effectively promote healing of low trans-sphincteric anal fistulas. The long-term efficacy is good and the procedure warrants wider use in clinical practice. International Scientific Literature, Inc. 2020-12-06 /pmc/articles/PMC7727077/ /pubmed/33279927 http://dx.doi.org/10.12659/MSM.928181 Text en © Med Sci Monit, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Clinical Research Tao, Yu Zheng, Yi Han, Jia Gang Wang, Zhen Jun Cui, Jin Jie Zhao, Bao Cheng Yang, Xin Qing Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title | Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title_full | Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title_fullStr | Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title_full_unstemmed | Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title_short | Long-Term Clinical Results of Use of an Anal Fistula Plug for Treatment of Low Trans-Sphincteric Anal Fistulas |
title_sort | long-term clinical results of use of an anal fistula plug for treatment of low trans-sphincteric anal fistulas |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727077/ https://www.ncbi.nlm.nih.gov/pubmed/33279927 http://dx.doi.org/10.12659/MSM.928181 |
work_keys_str_mv | AT taoyu longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT zhengyi longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT hanjiagang longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT wangzhenjun longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT cuijinjie longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT zhaobaocheng longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas AT yangxinqing longtermclinicalresultsofuseofananalfistulaplugfortreatmentoflowtranssphinctericanalfistulas |