Fistula plug versus conventional surgical treatment for anal fistulas A system review and meta-analysis

ABSTRACT

To evaluate the recurrence and fecal incontinence of anal fistula plug versus conventional surgical treatment for anal fistulas. This meta-analysis was carried out in the General Surgery Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. We searched the Medline, EMBASE, and the Cochrane Library from June 2011 to April 2012. The literature searches were carries out using medical subject headings and free-text word anal fistula, fibrin adhesive, fibrin sealant, and fistula plug. Two randomized controlled trials and 3 retrospective controlled studies were included. A total of 428 patients were included in our study. The recurrence rate was higher in those patients who accept fistula plug treatment [62.1% versus 47%] [p=0.004]. Anal fistula plug has a moderate probability of success with little risk of incontinence, but the recurrence rate is significantly higher than the conventional surgical treatment. This treatment is minimally invasive, repeatable, and sphinctersparing. This meta-analysis failed to find a statistically significant difference in incontinence rate between conservative treatment and conventional surgical treatment