Modern management of anal fistula

Table 1 Published articles on ligation of the intersphincteric fistula tract

Ref.	No. Patients	Follow-up (wk)	Healing rate	Complications	Type of study
Rojanasakul et al[23]	18	4	94%	NR	Prospective observational
Shanwani et al[26]	45	7	82%	NR	Prospective observational
Ellis et al[27]	31	6	94%	NR	Retrospective
Bleier et al[28]	39	10	57%	1 Anal fissure;	Retrospective
				1 Persistent pain
Ooi et al[29]	25	6	96%	NR	Prospective observational
Tan et al[30]	93	4	92%	NR	Retrospective review
Steiner et al[31]	18	6	83%	1 hemorrhoidal thrombosis	Retrospective
Aboulian et al[32]	25	24	68%	2 Vaginal fungal infection	Retrospective review
Mushaya et al[33]	25	4	68%	1 Secondary bleeding;	Prospective randomized
				2 Superficial perineal wound dehiscence
Abcarian et al[34]	50	15	74%	NR	Retrospective
Lo et al[35]	25	2	98%	NR	Retrospective
van Onkelen et al[36]	42	12	51%	NR	Prospective
Chen et al[37]	10	6	100%	NR	Retrospective
Lehmann et al[38]	17	4	47%	1 perianal haematoma;	Prospective
				1 wound infection
Liu et al[39]	38	26	61%	NR	Retrospective

Table 2 Published studies on anal fistula plug

Ref.	Type of study	No. Patients	Success rate	Follow-up (mo)
Johnson et al[41]	Prospective	15	87%	7
	Non-randomized
	Controlled trial
Champagne et al[44]	Prospective	46	83%	12
O’Connor et al[45]	Prospective	20 (Crohn’s)	80%	10
Van Koperen et al[46]	Prospective	17	42%	7
Ellis[47]	Retrospective	18 (5 rectovaginal)	88%	6
Lawes et al[48]	Retrospective	17 plug	66%	7.4
		3 pug+flap
Ky et al[49]	Prospective	44 plug+flap	54.6%	6.5
Schwandner et al[50]	Prospective	19 (7 Crohn’s)	61% overall	9
			45.5% cryptoglandular
			85.7% Crohn’s
Garg[51]	Prospective	21	71%	10
Christoforidis et al[52]	Retrospective	47	43%	6.5
Thekkinkattil et al[53]	Prospective	43	44%	11
Safar et al[54]	Retrospective	35	14%	4
Ortiz et al[55]	Prospective Randomized trial	31 cryptoglandular: -15 plug -16 endorectal-advancement flap (EAF)	20% (plug group) 87.5% (EAF)	12
El-Gazzaz et al[56]	Retrospective	33	25%	7.4
Chan et al[57]	Prospective	44	50%	10.5
Cintron et al[58]	Prospective	73	42.5%	15

Table 3 Published studies on GORE BioA fistula plug

Ref.	Study design	No. patients	Aetiology and classification	Healing-rate	Follow-up (mo)	Complications
Buchberg et al[61]	Retrospective	10	6 cryptoglandular	54%	2	NR
	Case-series		3 iatrogenic
			1 HIV
de la Portilla et al[62]	Prospective	19	10 high- transphincteric	16%	12	1 Acute sepsis
	Case-series		9 low transphicteric			1 Urge incontinence
						1 Plug extrusion
Ratto et al[63]	Prospective	11	11 High-	73%	5	NR
	Case-series		transphincteric
Ommer et al[64]	Retrospective	40	28 High-transphincteric	57.5%	12	1 Plug extrusion
	Case-series		12 Suprasphincteric			1 abscess
			4 Crohn’s			1 Dehiscence