Research Article
The Use of Biological ‘Infill’ Materials for the Treatment of Recto/Ano-vaginal Fistulae-A Systematic Review
Nuha A Yassin1*, Alan Askari1, John T Jenkins1, Ahmad Uraiqat1, Omar D Faiz1, Ailsa L Hart2 and Robin K S Phillips11Department of Colorectal Surgery, St Mark’s Hospital and Academic Institute, Watford Road, Harrow, HA1 3UJ, United Kingdom
2The IBD Unit, St Mark’s Hospital and Academic Institute, Watford Road, Harrow, HA1 3UJ, United Kingdom
- *Corresponding Author:
- Nuha A Yassin
St Mark’s Hospital and Academic Institute
Watford Road, Harrow
HA1 3UJ, United Kingdom
Tel: 0208 2354251
E-mail: nayassin@gmail.com
Received date: September 18, 2015; Accepted date: August 19, 2016; Published date: August 25, 2016
Citation: Yassin NA, Askari A, Jenkins JT, Uraiqat A, Faiz OD, et al. (2016) The Use of Biological ‘Infill’ Materials for the Treatment of Recto/Anovaginal Fistulae-A Systematic Review. J Gastrointest Dig Syst 6:465. doi: 10.4172/2161-069X.1000465
Copyright: © 2016 Yassin NA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.
Abstract
Aim: Recto-vaginal fistulae are distressing. They are most commonly caused by obstetric injury, a failed pelvic anastomosis, or Crohn’s disease. Biological infill materials have been used in their management. We assessed the efficacy of biological infill materials when recto-vaginal fistulae. Methods: We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-five articles yielded a pooled total of 105 patients; 27% had Crohn’s disease. Fifty-six percent of patients had treatment with glue, 31% with plug, 6% with permacol paste and 7% with stem-cells. For Crohn’s, 50% were treated with glue, 39% with a fistula plug and 11% with stem cells. The overall healing rate for all infill materials was 41%, with the highest reported rate amongst the stem cell group (71%) and the lowest (32%) for glue. For Crohn's, the overall healing rate was 36%, glue was the lowest (14%), followed by the anal fistula plug (55%). Stem cells had a healing rate of 67%. Conclusions: Overall, the use of infill materials to treat Crohn’s and non-Crohn’s related recto-vaginal fistulae is associated with healing in approximately 41% of cases. Crohn’s related recto-vaginal fistulae represent a more challenging group of patients to treat.
