Clinical PaperEfficacy of an anal fistula plug for fistulas-in-Ano in children☆,☆☆,★,★★
Section snippets
Patients
Between December 2006 and December 2015, 135 children (133 males and 2 females) with PAs and FIAs were treated at our hospital. None of the children had anorectal or inflammatory disease. Initially, all children were treated by conservative treatment with medication and local treatment. Children with PAs or FIAs had received conservative treatment with Juzentaihoto, a traditional herbal medicine that acts on the intestinal immune system. Antibiotics and stool softeners were not used. Local
Methods
All of the patients were treated under general anesthesia in the supine jackknife position. No seton was inserted prior to the operation. The fistula tract was washed with hydrogen peroxide, and a nylon string was then passed through the fistula tract. Using the nylon string as the guideline, an AFP was inserted along the full length of the fistula tract via the external opening of the tract. The AFP was sutured close to the internal opening with 5–0 absorbable suture. The internal opening was
Results
A total of 135 patients with PAs and FIAs were treated at this hospital. The male: female ratio was 133:2. Eighty of 135 patients (59.3%) had the first clinical symptoms younger than 5 months, and most patients (122 of 135: 90.4%) had them less than 11 months (Fig. 1). The overall formation rate of FIAs was 24 of 80 (30.0%) younger than 5 months at the first clinical symptom; 16 of 42 (38.1%) in 6 to 11 months old; 2 of 9 (22.2%) in one-year-olds; and 2 of 4 (50.0%) older than 2 years old.
Discussion
In children, PAs and FIAs occur overwhelmingly in boys [1], [2]. Conservative treatment involves administration of medication, such as antibiotics or stool softeners. Local treatment by needle aspiration or incision was performed. In infants, several papers have reported that the majority of PAs and FIAs resolved with conservative or local treatment [3], [4], [5], [9]. The overall incidence of PAs extending toward FIAs reported in the literature ranges from 20% to 77% [2], [3], [4], [5], [6],
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Cited by (4)
Benign anorectal disease in children: What do we know?
2022, Archives de PediatrieCitation Excerpt :Antibiotic usage for PA and fistula is controversial, with many studies characterizing them as beneficial and others reporting their application as ineffective in eradicating fistulas and preventing recurrences [36–38, 47]. Other efficacious surgical techniques less widely described in children are fibrin glue injection, anal fistula plug, defined as insertion of golf tee-shaped porcine collagen matrix in the fistula tract leading to closure, and video-assisted anal fistula treatment during which fistuloscopy and electrocoagulation with mucosal sleeve closure or the internal opening are performed [50–52]. To sum up, PA and fistulas are usually encountered during infancy.
Treatment of perianal abscess in children: spontaneous drainage or incision-drainage?
2022, Annals of Pediatric SurgeryAdvances in etiologies and treatments of infantile fistula-in-ano.
2021, Journal of Clinical Pediatric Surgery
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Financial disclosures, if any: Nothing
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The source(s) of support in the form of grants, equipment drugs, or all of these: Nothing
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State if meeting presentation-name of meeting, date and year: None
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Correspondence author performed all operation of the anal fistula plug insertion for children and each coauthor supported those.