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Original article
Factibility and Security Study of the PICS-AF™ Plug for the Treatment of Cryptoglandular Anal Fistula
Estudio de factibilidad y seguridad del plug de colágeno (PICS-AF™) en el tratamiento de la fístula anal criptoglandular
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Fernando de la Portillaa,b,
Corresponding author
fportilla@us.es

Corresponding author.
, María Luisa Reyes-Díaza, María Victoría Maestrea, Rosa María Jiménez-Rodrígueza, Ana María García-Cabreraa, José M. Díaz-Pavóna,c, Jorge Manuel Vázquez-Monchula, Juan Antonio Villanuevac
a Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen del Rocío/IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Sevilla, Spain
c Curaseal, Inc, Santa Clara, United States
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Table 1. Adverse Events.
Abstract
Introduction

The PICS-AF™ (Curaseal Inc.) device is a new plug made of collagen that has a retention system in the internal orifice. This pilot study was designed to assess both the feasibility and safety of this plug in the treatment of trans-sphincteric anal fístulas.

Methods

A total of 44 patients (34 men), with a mean age of 54.68±7.3, with trans-sphincteric anal fístulas were included in the study; 34 of them were analyzed. All patients were examined according to a strict preoperative protocol and until 6 months after surgery. The feasibility of the procedure and the adverse events were analyzed.

Results

Finally, 34 patients were operated on, and in 30 of them the plug was used. Therefore, the feasibility was calculated at 88%. There was a total of 16 adverse events, 4 recorded as not related (3 mild and one moderate) and 12 related to the procedure or to the device implanted. Of these, 5 were mild, 5 moderate and 2 severe. The majority of the events reported were related to proctalgia (4 patients) or infection at the implant site (4 patients).

Conclusions

The present study indicates that the new collagen plug can be placed effectively and with an acceptable complication rate.

Keywords:
Perianal fistula
Plug
Collagen
Resumen
Introducción

El dispositivo PICS-AF ™ es un nuevo tapón hecho de colágeno que tiene un sistema de retención en el orificio fistuloso interno. Este estudio piloto ha sido diseñado para evaluar la factibilidad y seguridad de este dispositivo en el tratamiento de las fístulas anales criptoglandulares transesfinterianas.

Métodos

Un total de 44 pacientes (34 hombres) con diagnóstico de fístula transesfinteriana fueron incluidos en el estudio, de los cuales 34 fueron seleccionados. Todos los pacientes fueron examinados según un protocolo estricto antes de la cirugía y hasta 6 meses después. Se analizaron la factibilidad del procedimiento y los acontecimientos adversos.

Resultados

El dispositivo se colocó sin incidencias en 30 de los 34 pacientes (factibilidad del 88%). Se evidenciaron un total de 16 acontecimientos adversos, 4registrados como no relacionados con el procedimiento (3 leves y uno moderado) y 12 relacionados con el procedimiento o el dispositivo implantado. De ellos, 5fueron leves, 5moderados y 2graves. La mayoría de los efectos adversos reportados fueron proctalgia (4 pacientes) o infección en el sitio del implante (4 pacientes).

Conclusiones

El presente estudio indica que el nuevo tapón de colágeno puede ser colocado de forma efectiva y con una tasa de complicaciones aceptable.

Palabras clave:
Fístula perianal
Plug
Colágeno

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