Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
Colorectal Dis. 2023 May;25(5):995-1001. doi: 10.1111/codi.16501. Epub 2023 Feb 21.
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.
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.
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.
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.
肛瘘是一种常见的疾病，治疗难度较大。近年来，由于报告的并发症（如失禁）发生率较低，“保留括约肌”的手术越来越受欢迎。其中一种治疗方法是瘘管塞，与其他技术相比，其成功率有所不同。目前市场上有几种塞子，不同的结果可能与使用的塞子类型有关。本研究旨在比较英国一家三级转诊中心使用两种不同瘘管塞的愈合率和并发症发生率。
我们对 18 岁以上接受择期瘘管塞插入术的所有患者进行了单中心回顾性分析，这些患者在 13 年期间使用了两种不同的瘘管塞。
共有 113 名患者接受了瘘管塞插入术（塞 A n=90；塞 B n=23）。塞 B 在研究期间的最后 4 年上市，因此患者人数不同。两种塞子的患者人口统计学特征、瘘管类型和瘘管病因均无差异。塞 B 的瘘管愈合率明显高于塞 A（56.5%比 12.2%；p<0.005）。四分之一的患者发生并发症，93%是插入塞 A 的患者。最常见的并发症是塞子在插入后 72 小时内脱出。
本研究根据使用的瘘管塞类型显示出明显不同的结果。虽然目前的随机对照试验在比较一种瘘管塞与其他治疗方式的愈合率时没有发现显著差异，但本研究表明塞子类型可能影响疗效。
