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

Garg, Pankaj; Song, Justin C. W.; Bhatia, Ankit; Kalia, Harmit; Menon, Geetha R

doi:10.1111/j.1463-1318.2009.01933.x

Cited by 112 publications

(73 citation statements)

References 30 publications

(45 reference statements)

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“…Since then, several studies on the AFP have been reported with variable results. A systematic review, based on observational studies, reported that the AFP has a moderate success rate of 35%-87% for complex fistula-in-ano [14] . In the present report, we performed a meta-analysis comparing the AFP and the MAF with the objective of evaluating the efficacy of the AFP for the treatment of patients with a complex fistula-in-ano.…”

Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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AIM:To investigate the efficacy of the anal fistula plug (AFP) compared to the mucosa advancement flap (MAF), considered the best procedure for patients with a complex anal fistula. METHODS:The literature search included PubMed, EMBASE, Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011. Randomized controlled trials, controlled clinical trials and prospective cohort studies were included in the review. After information collection, a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity. The quality of postoperative life was also included with the clinical results. RESULTS:Six studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 -0.14; RD = 0.13; 95%CI: -0.18 -0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 --0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 --0.00). The postoperative quality of life, for patients treated using the AFP was superior to that of the MAF patients. Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced. CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula; it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life. Additional evidence is needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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“…However, the literature mentions a high rate of recurrences and infective complications (sepsis, suppuration, or abscesses) following the use of such devices in anorectal conditions [3,4]. It is not unreasonable to expect some of these complications or recurrences when the plug is being used in a recto-urethral repair as well.…”

Section: Editormentioning

confidence: 99%

Apropos use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula

Batura

2017

Int Urol Nephrol

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“…Insgesamt wurden die Plug-Technik und weitere neue Verfahren in diversen Reviews aufgearbeitet [82,139,214,234,292,296,332,402]. Cirocchi et al [82] …”

Section: Reviews Zur Plug-technikunclassified