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Treatment of Perirectal Fistula With Cutting Seton vs. Collagen Plug

Phase 3
Completed
Conditions
Anal Fistula
Registration Number
NCT00450671
Lead Sponsor
University of Southern California
Brief Summary

The purpose of this study is to determine if the collagen plug method heals perirectal fistulae as well as the conventional seton method.

Detailed Description

Traditional treatments for transsphincteric perirectal fistulae rely upon an immediate (fistulotomy) or delayed (seton) transsection of the sphincter muscle possibly resulting in fecal incontinence, take a long time to heal, and/or are associated with significant failure rates (ex. fibrin glue).

Newer treatment concepts such as the collagen plug do not physically interrupt the sphincter muscle, avoid and minimize the risk of fecal incontinence, and decrease the time to fistula healing. Exciting initial reports have confirmed the collagen plug's utility in treating perirectal fistulae, but a systematic scientific comparison is needed to validate the new, less invasive plug method.

The primary goal of this study is to show that the collagen plug heals transsphincteric perirectal fistulae as well as the conventional seton method.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
300
Inclusion Criteria
  1. Patients that are undergoing surgery for perirectal fistulae by the USC Colorectal Group
  2. Patients that are older than 18 years of age and are able to understand and sign consent
  3. Patients that are suitable candidates for either seton or collagen plug placement
Exclusion Criteria
  1. Preoperative patient exclusion factors:

    • Pregnant patients
    • Patients with a tumor-related fistula
    • Patients with known allergies to porcine products
    • Patients with known Crohn's disease
  2. Intraoperative patient exclusion factors:

    • Patients with an active purulent infection (pus draining from the fistula tract or abscess associated with the fistula tract) at the time of surgery
    • Patients with a large diameter fistula (>3mm)
    • Patients with a superficial fistula
    • Patients with a short fistula (<1 cm in length)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Fistula healing
Treatment failure
Secondary Outcome Measures
NameTimeMethod
Time to treatment failure
Rates of postoperative fecal continence
Time to fistula healing

Trial Locations

Locations (4)

USC/University Hospital

🇺🇸

Los Angeles, California, United States

H.Claude Hudson Comprehensive Health Center

🇺🇸

Los Angeles, California, United States

Los Angeles County-USC Medical Center

🇺🇸

Los Angeles, California, United States

USC Norris Cancer Center

🇺🇸

Los Angeles, California, United States

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