Successful closure of gastrocutaneous fistulas using the Surgisis^® anal fistula plug

Abstract

INTRODUCTION Gastrocutaneous fistulas remain an uncommon complication of upper gastrointestinal surgery. Less common but equally problematic are gastrocutaneous fistulas secondary to non-healing gastrostomies. Both are associated with considerable morbidity and mortality. Surgical repair remains the gold standard of care. For those unfit for surgical intervention, results from conservative management can be disappointing. We describe a case series of seven patients with gastrocutaneous fistulas who were unfit for surgical intervention. These patients were managed successfully in a minimally invasive manner using the Surgisis ® (Cook Surgical, Bloomington, IN, US) anal fistula plug.

Endoscopic therapeutic interventions for management of postoperative bariatric surgery complications

“…Fistula closure success rates was 87.5% (7/8) patients with no serious adverse events reported [84]. A similar small case series of patients with gastrocutaneous fistulas, demonstrated 100% fistula closure rates at a median of 26 days [85].…”

Gastro-cutaneous fistula treated with trionic (cell alginate activate packing)

“…Darrien and Kasem have a series of seven patients whose fistula had been filled with Surgisis, two cases in which besides filling there had also been a clipping of the inner opening with an endoscope, whereas in other cases only the filling had been done. In these seven cases, there were no further problems [ 7 ]. Wood, with his fellow researchers, demonstrated a successful closure of a persistent gastrocutaneous fistula after removal of feeding gastrostomy in combination of clip in the inner opening with endoscopy [ 8 ].…”

Functional acellular matrix for tissue repair

“…The dECM formed using initiating materials is also denoted as refunctionalized dECM. Currently, several functionalized dECMs such as porcine heart valves [ 79 ] and porcine small intestine submucosa have been approved for clinical use by the Food and Drug Administration of the United States [ [80] , [81] , [82] , [83] ]. Thus, the functionalized dECM is a very promising material for tissue and organ repair.…”