{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:50:41Z","timestamp":1761238241389,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,1,4]],"date-time":"2016-01-04T00:00:00Z","timestamp":1451865600000},"content-version":"vor","delay-in-days":3,"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":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Recent advances in the treatment of fistula\u2010in\u2010ano have focused on surgical techniques that preserve sphincter integrity. Plugs that obliterate the lumen of the fistula track have been proposed as one such method, and may be derived from biological or delayed absorbable synthetic materials. Biological plugs have highly variable results and have not been widely adopted. The aim of this systematic review was to assess the effectiveness and safety of a delayed absorbable synthetic plug (<jats:styled-content style=\"fixed-case\">GORE<\/jats:styled-content>\u00ae <jats:styled-content style=\"fixed-case\">BIO<\/jats:styled-content>\u2010A\u00ae) for treatment of anal fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A systematic review of all literature in the English language relevant to the use of a plug to treat anal fistula and published between 1 January 2008 and 15 February 2015 was carried out by searching <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EMBASE<\/jats:styled-content> and the Cochrane Library of Systematic Reviews\/Controlled Trials for relevant literature. Relevant articles were identified, quality assessed using the methodological index for nonrandomized studies criteria and data were extracted by two independent researchers (<jats:styled-content style=\"fixed-case\">SKN<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NNA<\/jats:styled-content>). The identified articles were assessed with regard to fistula healing rate, duration of follow\u2010up and complication rates related to the use of delayed absorbable synthetic fistula plugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty six potential articles were identified from the literature search. Using the predefined inclusion and exclusion criteria, six were included in the final analysis, data extraction and data synthesis. Of these included in the review only three were prospective in design. Complete data were available for 187 of the 221 patients who underwent this treatment. The age of the participants ranged from 19 to 82\u00a0years. The fistula healing rates were reported to be between 15.8% and 72.7% at a follow\u2010up ranging between 2 and 19\u00a0months. Early or delayed plug extrusion occurred in 16 (8.5%) of the 187 patients. Deterioration in continence was reported in 11 (5.8%) of 187 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are insufficient high\u2010quality data on the delayed absorbable synthetic (<jats:styled-content style=\"fixed-case\">GORE<\/jats:styled-content>\u00ae <jats:styled-content style=\"fixed-case\">BIO<\/jats:styled-content>\u2010A\u00ae) fistula plug to draw meaningful conclusions regarding its effectiveness. It does, however, appear to be a simple and safe technique associated with low complication rates and a minor deterioration in continence in a few cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13208","type":"journal-article","created":{"date-parts":[[2015,11,6]],"date-time":"2015-11-06T07:55:17Z","timestamp":1446796517000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Delayed absorbable synthetic plug (<scp>GORE<\/scp>\u00ae <scp>BIO<\/scp>\u2010A\u00ae) for the treatment of fistula\u2010in\u2010ano: a systematic review"],"prefix":"10.1111","volume":"18","author":[{"given":"S. K.","family":"Narang","sequence":"first","affiliation":[{"name":"Exeter Surgical Health Services Research Unit (HeSRU) Royal Devon and Exeter Hospital Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Exeter Medical School Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. N.","family":"Alam","sequence":"additional","affiliation":[{"name":"Exeter Surgical Health Services Research Unit (HeSRU) Royal Devon and Exeter Hospital Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. R.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Exeter Surgical Health Services Research Unit (HeSRU) Royal Devon and Exeter Hospital Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-8324","authenticated-orcid":false,"given":"N. J.","family":"Smart","sequence":"additional","affiliation":[{"name":"Exeter Surgical Health Services Research Unit (HeSRU) Royal Devon and Exeter Hospital Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1272819"},{"key":"e_1_2_9_3_1","first-page":"219","article-title":"Fistula\u2010in\u2010ano in a defined population. Incidence and epidemiological aspects","volume":"73","author":"Sainio P","year":"1984","journal-title":"Ann Chir Gynaecol"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i28.3286"},{"key":"e_1_2_9_5_1","first-page":"707","article-title":"Cryptoglandular anal fistulas","volume":"108","author":"Ommer A","year":"2011","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01372.x"},{"key":"e_1_2_9_7_1","first-page":"581","article-title":"Total anal sphincter saving technique for fistula\u2010in\u2010ano; the ligation of intersphincteric fistula tract","volume":"90","author":"Rojanasakul A","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-014-1183-3"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01933.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-014-2091-8"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181a8fbb7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181d43b7d"},{"key":"e_1_2_9_13_1","first-page":"1584","article-title":"Anal fistula plug in high fistula\u2010in\u2010ano: an early Saudi experience","volume":"52","author":"Zubaidi A","year":"2009","journal-title":"Dis Colon Rectum"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181d972a9"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e3182839824"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i1.12"},{"key":"e_1_2_9_17_1","first-page":"213","article-title":"A new synthetic monofilament absorbable suture made from polytrimethylene carbonate","volume":"161","author":"Katz AR","year":"1985","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"e_1_2_9_19_1","unstructured":"OCEBM Levels of Evidence \u2013 CEBM.http:\/\/www.cebm.net\/ocebm-levels-of-evidence\/(accessed January 2015)."},{"key":"e_1_2_9_20_1","first-page":"Doc13","article-title":"Gore BioA Fistula Plug in the treatment of high anal fistulas \u2013 initial results from a German multicenter\u2010study","volume":"10","author":"Ommer A","year":"2012","journal-title":"Ger Med Sci"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007601030"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000288"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12127"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.02964.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e318239d1e4"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-013-1050-7"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000288"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13208","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T03:56:43Z","timestamp":1694663803000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.1111\/codi.13208"],"URL":"https:\/\/doi.org\/10.1111\/codi.13208","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"type":"print","value":"1462-8910"},{"type":"electronic","value":"1463-1318"}],"subject":[],"published":{"date-parts":[[2016,1]]},"assertion":[{"value":"2015-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}