Review of outcomes of Anal Fistula Plugs (AFP) in the treatment of Complex fistula-in-ano
EAES Academy. Bukhari S. 07/05/22; 362974; P017
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Abstract
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Introduction
The AFP is an attractive option in the management of Trans-sphincteric fistula –in-ano
The proposed benefits of the procedure are that it is minimally invasive, safe with minimal risk to continence. We aimed to correlate between length of TranSphincteric Fistula Tract on MRI, and success rates using AFP to define its use more specifically.
Methods
Retrospective review of AFP at a District General Hospital (single surgeon’s data). Anatomically fistulae were classified on MRI as Extrasphincteric , Intersphincteric, Transphincteric , Ano-vaginal and Complex . The outcome measures were healing rates at all follow ups within 4 years, Recurrence rates within 6 weeks , Re-intervention rates and Faecal incontinence rates and cost effectiveness.
Results:
The study included 33 patients (age 20-79 years), Male 22, Female 11. Majority of fistulae were transphincteric (15) and the median length of the fistula tract was 6.4cm(2.5 – 18.3) cm, Median follow up was 38 months. Healing rate was 49.5% (16), with a recurrence rate of 57.5% (18). Incontinence rate was 0% and Re-intervention rate was 21% (7).
Conclusions:
AFP, mostly used for Trans-sphincteric fistulae, is minimally invasive and safe procedure with very minimal risk to continence. However , the recurrence rates are high and is expensive. Study needs to be validated with prospective RCTs and other studies with longer follow up.
The AFP is an attractive option in the management of Trans-sphincteric fistula –in-ano
The proposed benefits of the procedure are that it is minimally invasive, safe with minimal risk to continence. We aimed to correlate between length of TranSphincteric Fistula Tract on MRI, and success rates using AFP to define its use more specifically.
Methods
Retrospective review of AFP at a District General Hospital (single surgeon’s data). Anatomically fistulae were classified on MRI as Extrasphincteric , Intersphincteric, Transphincteric , Ano-vaginal and Complex . The outcome measures were healing rates at all follow ups within 4 years, Recurrence rates within 6 weeks , Re-intervention rates and Faecal incontinence rates and cost effectiveness.
Results:
The study included 33 patients (age 20-79 years), Male 22, Female 11. Majority of fistulae were transphincteric (15) and the median length of the fistula tract was 6.4cm(2.5 – 18.3) cm, Median follow up was 38 months. Healing rate was 49.5% (16), with a recurrence rate of 57.5% (18). Incontinence rate was 0% and Re-intervention rate was 21% (7).
Conclusions:
AFP, mostly used for Trans-sphincteric fistulae, is minimally invasive and safe procedure with very minimal risk to continence. However , the recurrence rates are high and is expensive. Study needs to be validated with prospective RCTs and other studies with longer follow up.
Introduction
The AFP is an attractive option in the management of Trans-sphincteric fistula –in-ano
The proposed benefits of the procedure are that it is minimally invasive, safe with minimal risk to continence. We aimed to correlate between length of TranSphincteric Fistula Tract on MRI, and success rates using AFP to define its use more specifically.
Methods
Retrospective review of AFP at a District General Hospital (single surgeon’s data). Anatomically fistulae were classified on MRI as Extrasphincteric , Intersphincteric, Transphincteric , Ano-vaginal and Complex . The outcome measures were healing rates at all follow ups within 4 years, Recurrence rates within 6 weeks , Re-intervention rates and Faecal incontinence rates and cost effectiveness.
Results:
The study included 33 patients (age 20-79 years), Male 22, Female 11. Majority of fistulae were transphincteric (15) and the median length of the fistula tract was 6.4cm(2.5 – 18.3) cm, Median follow up was 38 months. Healing rate was 49.5% (16), with a recurrence rate of 57.5% (18). Incontinence rate was 0% and Re-intervention rate was 21% (7).
Conclusions:
AFP, mostly used for Trans-sphincteric fistulae, is minimally invasive and safe procedure with very minimal risk to continence. However , the recurrence rates are high and is expensive. Study needs to be validated with prospective RCTs and other studies with longer follow up.
The AFP is an attractive option in the management of Trans-sphincteric fistula –in-ano
The proposed benefits of the procedure are that it is minimally invasive, safe with minimal risk to continence. We aimed to correlate between length of TranSphincteric Fistula Tract on MRI, and success rates using AFP to define its use more specifically.
Methods
Retrospective review of AFP at a District General Hospital (single surgeon’s data). Anatomically fistulae were classified on MRI as Extrasphincteric , Intersphincteric, Transphincteric , Ano-vaginal and Complex . The outcome measures were healing rates at all follow ups within 4 years, Recurrence rates within 6 weeks , Re-intervention rates and Faecal incontinence rates and cost effectiveness.
Results:
The study included 33 patients (age 20-79 years), Male 22, Female 11. Majority of fistulae were transphincteric (15) and the median length of the fistula tract was 6.4cm(2.5 – 18.3) cm, Median follow up was 38 months. Healing rate was 49.5% (16), with a recurrence rate of 57.5% (18). Incontinence rate was 0% and Re-intervention rate was 21% (7).
Conclusions:
AFP, mostly used for Trans-sphincteric fistulae, is minimally invasive and safe procedure with very minimal risk to continence. However , the recurrence rates are high and is expensive. Study needs to be validated with prospective RCTs and other studies with longer follow up.
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