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Colorectal Diseases

Surgisis AFP plug for anal fistula

08/25/2008

Question:

I have an perianal fistula draining with multiple external openings all going to one internal opening. Two colorectal surgeons and one gastro doctor states this is due to my Crohn`s Disease of 28 years although mine was always confined previously to the terminal ileum with two prior small bowel resections. Setons have been in place for about nine months now.

I have researched the Surgisis AFP Plug and their material states it can work for anal fistulas with people who have Crohn`s. What is your opinion of the AFP plug and is it possible it will work for me?

Thanks.

Answer:

The AFP may indeed work for complex fistulas. It is successful in up to 80% of fistula repairs for which it is used. Some surgeons seem to have greater success with this technology than others. However the most important factor in healing a fistula due to Crohn's disease, no matter how it is repaired, is the extent of inflammation at the internal opening. Medical therapy should be optimized, and all pus should be well-drained, prior to an attempt at repair.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati