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Article: Porcine dermal collagen mesh (Permacol™) as a bioprosthesis in the ligation of intersphincteric tract (BioLIFT) procedure

TitlePorcine dermal collagen mesh (Permacol™) as a bioprosthesis in the ligation of intersphincteric tract (BioLIFT) procedure
Authors
KeywordsAnal fistula
Ligation of intersphincteric tract
BioLIFT
Issue Date2020
PublisherSpringer - Verlag Italia Srl. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/10151
Citation
Techniques in Coloproctology, 2020, v. 24 n. 12, p. 1277-1283 How to Cite?
AbstractBackground Ligation of intersphincteric tract (LIFT) is a sphincter-saving technique used to treat anal fistulas. Incorporation of a bioprosthesis in LIFT (BioLIFT) aims to improve healing. The use of cross-linked porcine dermal collagen mesh Permacol (TM) in BioLIFT has never been investigated. The aim of this study was to compare the healing rates and outcome of LIFT and BioLIFT for complex anal fistulas using the Permacol (TM) biological mesh. Methods A retrospective analysis of all patients having LIFT or BioLIFT for complex fistulas from January 2010 to November 2019 was performed in a tertiary referral centre. Patient data from a prospectively collected database of all patients having LIFT or BioLIFT were analyzed. Results LIFT and BioLIFT were performed in 48 (82.8%) and 10 (17.2%) patients, respectively. All BioLIFT patients had previous interventions for their fistulas compared to 30 (62.5%) of patients who had LIFT,p = 0.023. The primary healing rate for LIFT was 87.5% (42/48) compared to 80% (8/10) in BioLIFT, (p = 0.42). Eight (13.8%) patients developed complications, 6 (12.5%) in the LIFT group vs 2 (20%) in the BioLIFT group (p = 0.62). On univariate analysis, the number of previous operations was predictive of complications (p = 0.03). BioLIFT was not associated with complication (OR = 1.75, 95% CI: 0.30-10.3,p = 0.54) or primary healing (OR = 0.57, 95% CI: 0.97-3.36,p = 0.54). There was no significant difference in recurrence (LIFT 12.5% vs BioLIFT 0%,p = 0.58). Kaplan-Meier analysis found no difference in time to recurrence between the two groups (p = 0.65). Conclusion Permacol (TM) mesh in BioLIFT is feasible and achieves a high primary healing rate of 80%. Prospective evidence is needed to establish the benefits of BioLIFT and determine whether Permacol (TM) is superior to the non-cross-linked porcine submucosal mesh.
Persistent Identifierhttp://hdl.handle.net/10722/295913
ISSN
2023 Impact Factor: 2.7
2023 SCImago Journal Rankings: 0.878
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTsang, JS-
dc.contributor.authorChan, TY-
dc.contributor.authorCheung, HH-
dc.contributor.authorWei, R-
dc.contributor.authorFoo, CC-
dc.contributor.authorLo, OSH-
dc.date.accessioned2021-02-08T08:15:49Z-
dc.date.available2021-02-08T08:15:49Z-
dc.date.issued2020-
dc.identifier.citationTechniques in Coloproctology, 2020, v. 24 n. 12, p. 1277-1283-
dc.identifier.issn1123-6337-
dc.identifier.urihttp://hdl.handle.net/10722/295913-
dc.description.abstractBackground Ligation of intersphincteric tract (LIFT) is a sphincter-saving technique used to treat anal fistulas. Incorporation of a bioprosthesis in LIFT (BioLIFT) aims to improve healing. The use of cross-linked porcine dermal collagen mesh Permacol (TM) in BioLIFT has never been investigated. The aim of this study was to compare the healing rates and outcome of LIFT and BioLIFT for complex anal fistulas using the Permacol (TM) biological mesh. Methods A retrospective analysis of all patients having LIFT or BioLIFT for complex fistulas from January 2010 to November 2019 was performed in a tertiary referral centre. Patient data from a prospectively collected database of all patients having LIFT or BioLIFT were analyzed. Results LIFT and BioLIFT were performed in 48 (82.8%) and 10 (17.2%) patients, respectively. All BioLIFT patients had previous interventions for their fistulas compared to 30 (62.5%) of patients who had LIFT,p = 0.023. The primary healing rate for LIFT was 87.5% (42/48) compared to 80% (8/10) in BioLIFT, (p = 0.42). Eight (13.8%) patients developed complications, 6 (12.5%) in the LIFT group vs 2 (20%) in the BioLIFT group (p = 0.62). On univariate analysis, the number of previous operations was predictive of complications (p = 0.03). BioLIFT was not associated with complication (OR = 1.75, 95% CI: 0.30-10.3,p = 0.54) or primary healing (OR = 0.57, 95% CI: 0.97-3.36,p = 0.54). There was no significant difference in recurrence (LIFT 12.5% vs BioLIFT 0%,p = 0.58). Kaplan-Meier analysis found no difference in time to recurrence between the two groups (p = 0.65). Conclusion Permacol (TM) mesh in BioLIFT is feasible and achieves a high primary healing rate of 80%. Prospective evidence is needed to establish the benefits of BioLIFT and determine whether Permacol (TM) is superior to the non-cross-linked porcine submucosal mesh.-
dc.languageeng-
dc.publisherSpringer - Verlag Italia Srl. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/10151-
dc.relation.ispartofTechniques in Coloproctology-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI]-
dc.subjectAnal fistula-
dc.subjectLigation of intersphincteric tract-
dc.subjectBioLIFT-
dc.titlePorcine dermal collagen mesh (Permacol™) as a bioprosthesis in the ligation of intersphincteric tract (BioLIFT) procedure-
dc.typeArticle-
dc.identifier.emailTsang, JS: julianst@hku.hk-
dc.identifier.emailWei, R: rwei@hku.hk-
dc.identifier.emailFoo, CC: ccfoo@hku.hk-
dc.identifier.emailLo, OSH: oswens@hku.hk-
dc.identifier.authorityFoo, CC=rp01899-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10151-020-02325-3-
dc.identifier.pmid32813119-
dc.identifier.scopuseid_2-s2.0-85089515060-
dc.identifier.hkuros321178-
dc.identifier.volume24-
dc.identifier.issue12-
dc.identifier.spage1277-
dc.identifier.epage1283-
dc.identifier.isiWOS:000561003000001-
dc.publisher.placeItaly-

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