Abstract

GROSSBERG, SJ; HARRAN, N; BEBINGTON, B  and  LUTRIN, DL. Use of the OVESCO OTSC® Proctology Clip for closure of fistula-in-ano at Wits Donald Gordon Medical Centre - a single centre experience. S. Afr. j. surg. [online]. 2020, vol.58, n.2, pp.74-77. ISSN 2078-5151.  http://dx.doi.org/10.17159/2078-5151/2020/v58n2a3131.

BACKGROUND: Definitive closure of fistula-in-ano poses an ongoing surgical challenge. The OVESCO OTSC® Proctology Clip (proctology clip) purports to offer improved preservation of the anal sphincter whilst at the same time curing the fistula by closureMETHODS: A retrospective record review was conducted for patients who received the proctology clip as part of the management of fistula-in-ano in the Colorectal Unit at Wits Donald Gordon Medical Centre (WDGMCRESULTS: There were 19 cases of fistula-in-ano treated with the proctology clip. All were cryptoglandular in origin. The median age was 50 years (IQR 44-56 years) and post-procedure, the median follow-up duration was 145 days (IQR 63-298 days). Overall, 9 procedures were successful (47%). Success rates were higher for simple (66.7%) as opposed to complex (38.5%) fistula-in-ano. For patients who underwent placement of the proctology clip as a primary procedure, the success rate (50%) was slightly better than those who received the clip as a secondary procedure (44.4%CONCLUSION: This preliminary data presents our initial experience using the proctology clip. While these data may serve as a "proof of concept", a multi-centre controlled trial comparing this method to the rectal mucosal advancement flap (RMAF) is needed to determine the role of the proctology clip in the management of fistula-in-ano

Keywords : anal fistula; OVESCO OTSC® Proctology Clip.

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