Lupinacci R M, Vallet C, Parc Y, Chafai N, Tiret E
Service de chirurgie générale et digestive, hôpital Saint-Antoine, AP-HP, université Pierre-et-Marie-Curie, Paris-VI, 184 rue du Faubourg-Saint-Antoine, Paris cedex 12, France.
Gastroenterol Clin Biol. 2010 Oct;34(10):549-53. doi: 10.1016/j.gcb.2009.06.021. Epub 2010 Sep 6.
Closure of the fistula tract with an anal fistula plug has been reported to provide success rates as high as 80%. The purpose of this study was to evaluate our results with this new method.
From June 2006 to September 2007, an anal fistula plug was used for the treatment of high transsphincteric fistulas. Success was defined as no residual leakage or abscess formation and closure of the external opening.
Fifteen patients (seven women), median age 46 years (range 32-58 years), were included in the study. Three had Crohn's disease, three had an anovulvar fistula and seven had undergone previous surgical-repair attempts. Three patients expelled the prosthesis on postoperative day 2, 5 and 7, respectively, and a second plug placement was followed by expulsion again. One patient developed an abscess that was noted on postoperative day 4. The fistula tract healed in 6/15 patients (40%) after 3 months and in 8/15 (53.3%) after 7 months. The success rate in Crohn's disease was 33%. No significant difference was found between patients with or without previous surgical repair.
In our experience, this simple technique provided success rates of 40% at 3 months and 53% at 7 months.
据报道，使用肛瘘塞封闭瘘管的成功率高达80%。本研究的目的是评估我们采用这种新方法的结果。
2006年6月至2007年9月，采用肛瘘塞治疗高位经括约肌肛瘘。成功定义为无残余渗漏或脓肿形成且外口闭合。
15例患者（7名女性）纳入研究，中位年龄46岁（范围32 - 58岁）。3例患有克罗恩病，3例患有肛门外阴瘘，7例曾接受过手术修复尝试。3例患者分别在术后第2天、第5天和第7天排出假体，再次放置第二个塞子后又被排出。1例患者在术后第4天出现脓肿。3个月后，15例患者中有6例（40%）瘘管愈合，7个月后有8例（53.3%）愈合。克罗恩病患者的成功率为33%。既往有或无手术修复的患者之间未发现显著差异。
根据我们的经验，这种简单技术在3个月时成功率为40%，7个月时为53%。
