What are the surgical options for complex anal fistulas?

Updated: Nov 09, 2018
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

For complex fistulas, debridement and fibrin glue or fistula plug may be used. Success rates for fibrin glue range from 10-67%. Although it has a relatively low success rate, recent guidelines suggest that fibrin glue may be used as first-line therapy. [21] Likewise, variable success has been reported with fistula plugs. One small trial described a success rate of 72.7% with the use of the Gore Bio-A fistula plug. [48] Endoanal advancement flaps also have variable success rates for the treatment of complex fistulas.


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