Zubaidi Ahmad, Al-Obeed Omar
General Surgery Division, Surgery, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Dis Colon Rectum. 2009 Sep;52(9):1584-8. doi: 10.1007/DCR.0b013e3181a90b65.
The Surgisis AFP anal fistula plug is a bioabsorbable xenograft designed to assist in the closure of anorectal fistulas. Its efficacy was studied in a series of patients at King Khalid University Hospital, in Riyadh, Saudi Arabia.
Patients with chronic and/or complicated anorectal fistulas were prospectively studied. Diagnoses were made by clinical, radiographic, or endoscopic criteria. The number of fistula tracts (based on the number of primary openings) and the duration of draining setons was recorded. Under general anesthesia, patients underwent identification and irrigation of the fistula tracts using hydrogen peroxide. The anal fistula plug was used to occlude the primary opening for each high anal/anorectal fistula not amenable to fistulotomy. The plug was securely sutured into place at the primary opening using absorbable suture.
Twenty-two consecutive patients were prospectively enrolled. In total, 23 fistula tracts were treated. Three anorectal fistulas failed to close early in the study, but two failures were attributed to technical error. Both patients refused to undergo a second procedure. The third failure occurred because of recurrent Crohn's disease. After a mean follow-up of 12 months, 19 of the 23 fistula tracts remained successfully closed, for an overall success rate of 83%. There was no relationship between closure of the fistula and the presence of draining setons.
In our experience, closure of cryptoglandular anorectal fistula tracts using the Surgisis AFP anal fistula plug is safe and successful in 83% of fistula tracts at 12 months of follow-up.
Surgisis AFP肛瘘栓是一种生物可吸收异种移植物，旨在帮助闭合肛肠瘘。在沙特阿拉伯利雅得的哈立德国王大学医院，对一系列患者研究了其疗效。
对慢性和/或复杂性肛肠瘘患者进行前瞻性研究。通过临床、影像学或内镜标准进行诊断。记录瘘管数量（基于原发开口数量）和引流挂线的持续时间。在全身麻醉下，患者使用过氧化氢对瘘管进行识别和冲洗。对于每个不适于瘘管切开术的高位肛瘘/肛肠瘘，使用肛瘘栓堵塞原发开口。使用可吸收缝线将栓塞牢固地缝合在原发开口处。
前瞻性纳入了22例连续患者。共治疗了23条瘘管。在研究早期，有3例肛肠瘘未闭合，但其中2例失败归因于技术失误。这两名患者均拒绝接受第二次手术。第三次失败是由于克罗恩病复发。平均随访12个月后，23条瘘管中有19条仍成功闭合，总体成功率为83%。瘘管闭合与引流挂线的存在之间无相关性。
根据我们的经验，使用Surgisis AFP肛瘘栓闭合隐窝腺性肛肠瘘管在随访12个月时，83%的瘘管安全且成功。
