Surgery
Volume 147, Issue 1 , Pages 72-78 , January 2010

To plug or not to plug: A cost-effectiveness analysis for complex anal fistula

  • Michel Adamina, MD, MSc

      Affiliations

    • Department of Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Jeffrey S. Hoch, PhD

      Affiliations

    • Centre for Research on Inner City Health, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
    • ,
  • Marcus J. Burnstein, MD

      Affiliations

    • Department of Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests: Marcus J. Burnstein, MD, St Michael's Hospital, Department of Colorectal Surgery, 30 Bond Street, Cardinal Carter Wing, Room 16-046, Toronto, Ontario M5B 1W8, Canada.

,Accepted 18 May 2009.

References 

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  3. Oliver I, Lacueva FJ, Perez VF, et al. Randomized clinical trial comparing simple drainage of anorectal abscess with and without fistula track treatment. Int J Colorectal Dis. 2003;18:107–110
  4. Vasilevsky CA, Gordon PH. The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum. 1984;27:126–130
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  8. Garcia-Aguilar J, Belmonte C, Wong DW, Goldberg SM, Madoff RD. Cutting seton versus two-stage seton fistulotomy in the surgical management of high anal fistula. Br J Surg. 1998;85:243–245
  9. Pearl RK, Andrews JR, Orsay CP, et al. Role of the seton in the management of anorectal fistulas. Dis Colon Rectum. 1993;36:573–577
  10. Athanasiadis S, Kohler A, Nafe M. Treatment of high anal fistulae by primary occlusion of the internal ostium, drainage of the intersphincteric space, and mucosal advancement flap. Int J Colorectal Dis. 1994;9:153–157
  11. Mizrahi N, Wexner SD, Zmora O, et al. Endorectal advancement flap: are there predictors of failure?. Dis Colon Rectum. 2002;45:1616–1621
  12. van der Hagen SJ, Baeten CG, Soeters PB, van Gemert WG. Long-term outcome following mucosal advancement flap for high perianal fistulas and fistulotomy for low perianal fistulas: recurrent perianal fistulas: failure of treatment or recurrent patient disease?. Int J Colorectal Dis. 2006;21:784–790
  13. Champagne BJ, O'Connor LM, Ferguson M, Orangio GR, Schertzer ME, Armstrong DN. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up. Dis Colon Rectum. 2006;49:1817–1821
  14. Lawes DA, Efron JE, Abbas M, Heppell J, Young-Fadok TM. Early experience with the bioabsorbable anal fistula plug. World J Surg. 2008;32:1157–1159
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  16. Ky AJ, Sylla P, Steinhagen R, Steinhagen E, Khaitov S, Ly EK. Collagen fistula plug for the treatment of anal fistulas. Dis Colon Rectum. 2008;51:838–843
  17. Schwandner O, Stadler F, Dietl O, Wirsching RP, Fuerst A. Initial experience on efficacy in closure of cryptoglandular and Crohn's transsphincteric fistulas by the use of the anal fistula plug. Int J Colorectal Dis. 2008;23:319–324
  18. Ellis CN. Bioprosthetic plugs for complex anal fistulas: an early experience. J Surg Educ. 2007;64:36–40
  19. Christoforidis D, Etzioni DA, Goldberg SM, Madoff RD, Mellgren A. Treatment of complex anal fistulas with the collagen fistula plug. Dis Colon Rectum. 2008;51:1482–1487
  20. Gordon PH. Anorectal abscesses and fistula-in-ano. In:  Gordon PH,  Nivatvongs S editor. Principles and practice of surgery for the colon, rectum, and anus. 3rd ed. New York: Informa Healthcare; 2007;p. 191–234
  21. Drummond MF. Cost analysis. In:  Drummond MF,  Sculpher MJ,  Torrance GW,  O'Brien BJ,  Stoddart GL editor. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford (UK): Oxford University Press; 2005;p. 55–95
  22. Ministry of Health and Long Term Care, Ontario, Ontario Guide to Case Costing, Ontario Case Costing Initiative. http://www.occp.com/guide/o_guide.htm. Accessed July 12, 2008.
  23. Ontario Ministry of Health and Long-Term Care. Ontario health insurance schedule of benefits and fees. Ontario Ministry of Health and Long-Term Care. http://www.health.gov.on.ca/english/providers/program/ohip/sob/sob_mn.html. Published June 3, 2008. Accessed July 12, 2008.
  24. Bank of Canada. Data source: Statistics Canada, Consumer Price Indexes for Canada, monthly, 1914-2006. Rates and statistics: inflation calculator. Bank of Canada. http://www.bankofcanada.ca/en/rates/inflation_calc.html. Accessed April 28, 2008.
  25. Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum. 2006;49:371–376
  26. Buchanan GN, Bartram CI, Phillips RK, et al. Efficacy of fibrin sealant in the management of complex anal fistula: a prospective trial. Dis Colon Rectum. 2003;46:1167–1174
  27. Loungnarath R, Dietz DW, Mutch MG, Birnbaum EH, Kodner IJ, Fleshman JW. Fibrin glue treatment of complex anal fistulas has low success rate. Dis Colon Rectum. 2004;47:432–436
  28. Singer M, Cintron J, Nelson R, et al. Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or surgical closure of the internal fistula opening. Dis Colon Rectum. 2005;48:799–808

PII: S0039-6060(09)00363-8

doi: 10.1016/j.surg.2009.05.018

Surgery
Volume 147, Issue 1 , Pages 72-78 , January 2010

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