A retrospective review of chronic anal fistulae treated by anal fistulae plug

<jats:title>Abstract</jats:title><jats:p><jats:bold>Objective </jats:bold> The aim of this study was to analyse the efficacy of the anal fistulae plug (Cook Surgisis® AFP™) for the management of complex anal fistulae.</jats:p><jats:p><jats:bold>Method </jats:bold> A review of patients with anal fistulae treated using Cook Surgisis® AFP™ between October 2005 and 2007 was undertaken. Patient’s demographics, fistulae aetiology and success rates were recorded.</jats:p><jats:p><jats:bold>Results </jats:bold> Thirty‐three patients underwent 49 plug insertions. The median age was 44.4 years; 18 females. The fistulae aetiology was cryptoglandular in 61% and Crohn’s disease in 39%. The median follow up 221.5 days (range 44–684). Twenty‐one patients had previous failed surgery. Twenty‐eight patients had draining setons <jats:italic>in situ</jats:italic> at time of plug placement. The overall success rate was 8/32 patients (25%). Two of the 22 Crohn’s fistulae healed (9.1%) and 9/26(34.6%) cryptoglandular fistulae healed. The reasons for failure were sepsis in 87% and plug dislodgement in 13%. Significant predictor factors for improved outcome were African‐Americans patients (<jats:italic>P</jats:italic> = 0.009), and presence of seton (<jats:italic>P</jats:italic> = 0.05).</jats:p><jats:p><jats:bold>Conclusions </jats:bold> Anal fistulae plug was associated with a lower success rate than previously reported. Septic complications were the main reason for failure.</jats:p>