{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:24:14Z","timestamp":1782602654263,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,6,12]],"date-time":"2014-06-12T00:00:00Z","timestamp":1402531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Curing complex anal fistula without compromising continence can be extremely challenging. This study investigated the healing rate, continence and quality of life of patients after treatment of complex anal fistula of cryptoglandular origin with a bioprosthetic plug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Consecutive patients were prospectively followed in four referral centres. Following seton conditioning, a bioprosthetic plug was inserted into the fistula and sutured to the anal sphincter. Clinical evaluation was performed at 10\u00a0days, 6\u00a0weeks and 6\u00a0months after surgery, and was completed by telephone interviews. Anal continence and quality of life were evaluated using the Fecal Incontinence Score Index and the Short Form\u201036 Health Survey, version 2 (<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201036 v2) questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six patients presenting with a complex anal fistula and a median of three previous fistula surgeries were included. The 6\u2010month recurrence rate was 30.7% (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 15.9\u201342.8%), increasing to 48.0% (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 30.6\u201361.1%) after 2\u00a0years. Follow up was continued for a median of 68.1\u00a0months, and 26 (56.5%) recurrences were identified. Anal continence improved from a median of 19 points to 12 points at 6\u00a0months of follow up (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). Quality of life markedly improved in all scales. The physical summary score increased from 47.2 to 56.2 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and the mental summary score increased from 48.5 to 55.3 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The bioprosthetic fistula plug demonstrated a healing rate close to 50% in complex cryptoglandular fistula. Also, it markedly improved anal continence and quality of life. These data support the use of a bioprosthetic plug as first\u2010line therapy for complex fistula instead of more aggressive and potentially debilitating surgical options.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12594","type":"journal-article","created":{"date-parts":[[2014,2,13]],"date-time":"2014-02-13T07:54:50Z","timestamp":1392278090000},"page":"547-554","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Anal fistula plug: a prospective evaluation of success, continence and quality of life in the treatment of complex fistulae"],"prefix":"10.1111","volume":"16","author":[{"given":"M.","family":"Adamina","sequence":"first","affiliation":[{"name":"Department of Surgery Kantonsspital St. Gallen St. Gallen Switzerland"},{"name":"Department of Surgery Women's College Hospital Toronto ON Canada"},{"name":"Department of Surgery Mount Sinai Hospital Toronto ON Canada"},{"name":"Department of Surgery St Michael's Hospital Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Surgery Women's College Hospital Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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