Improved fistula plug outcome depends on the type of plug: a single‐centre retrospective study

Adele E Sayers*, Matthew J Lee, Steve R Brown

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Fistula-in-ano is a common condition that is potentially difficult to treat. In recent years ‘sphincter-sparing’ procedures have increased in popularity due to the lower rates of reported complications, such as incontinence. One such treatment is the fistula plug, which has seen varied success compared with other techniques. There are currently several plugs on the market and it is possible that difference in outcomes could be linked to the type of plug used. The aim of this study was to compare healing and complication rates between two fistula plugs in a single tertiary referral centre in the UK.

Method: We conducted a single-centre retrospective analysis of all patients over the age of 18 years who underwent elective fistula plug insertion, with two different fistula plugs over a 13-year period.

Results: A total of 113 patients underwent fistula plug insertion (plug A n = 90; plug B n = 23). Plug B had been on the market for the final 4 years of the study period, hence the differing patient numbers. There was no difference in patient demographics, fistula type or aetiology of the fistula between the two plugs. Plug B had a significantly higher fistula healing rate compared with plug A (56.5% vs. 12.2%; p < 0.005). A quarter of all patients experienced a complication, 93% being those who had fistula plug A inserted. The most common complication was extrusion of the plug within 72 h of insertion.

Conclusion: This study demonstrated significantly different outcomes according to the type of fistula plug used. Whilst current randomized controlled trials have not found a significant difference in healing rates when comparing one type of fistula plug to other treatment modalities, this study suggests that plug type may influence efficacy.
Original languageEnglish
Pages (from-to)995-1001
Number of pages7
JournalColorectal Disease
Volume25
Issue number5
Early online date2 Feb 2023
DOIs
Publication statusPublished - May 2023

Keywords

  • cohort
  • fistula
  • fistula plug

Fingerprint

Dive into the research topics of 'Improved fistula plug outcome depends on the type of plug: a single‐centre retrospective study'. Together they form a unique fingerprint.

Cite this