Treatment of complex
anal fistula is a surgical challenge because the risk of sphincter injury with the possibility of developing
fecal incontinence. There are many techniques for the treatment of anal
fistulas such as fistulotomy, fistulectomy, seton, endorectal advancement flap and
fibrin glue, with different rates of recurrence and
fecal incontinence. The
biologic plug Surgisis® AFP it's being used since 2006 and produces the closure of the
fistula in approximately 12 weeks, without surgery, by replacement of the fistulous tract by cells of the patient, apparently having advantages over other techniques.We retrospectively reviewed the results of 46 patients with complex anorectal
fistula treated with the
biological plug over a period of 4 years. Of these, 34 were men (73.9%) and 12 women, the mean age was 47.2 years. According the type of
fistula, 41 were recurrent
fistulas (89.1%) and 5 high transsphincteric
fistulas (10.8%). Patients underwent surgery on average 2.2 times previously. The
anal fistula plug was successful in 73.9% of cases with a median follow-up 29.8 months. Use of
anal fistula plug Surgisis® AFP is a new alternative with acceptable results in terms of recurrence comparable to other techniques, but with no incontinence.