Fibrin Glue Treatment of Complex Anal Fistulas Has Low Success Rate

• DOI: 10.1007/s10350-003-0076-8
• Publication Date: 2004-03-30T13:54:07Z
• Authors: Rasmy Loungnarath; David W. Dietz; Matthew G. Mutch; Elisa H. Birnbaum; Ira J. Kodner; James W. Fleshman
• Keywords: Fistulotomy; Coloanal anastomosis

Fibrin glue has been used to treat anal fistulas in an attempt avoid more radical surgical intervention. Reported success rates vary widely. The purpose of this study was review the use fibrin management complex at a tertiary referral center.This designed as retrospective all patients treated with injection for Section Colon and Rectal Surgery, Washington University School Medicine/Barnes-Jewish Hospital. Demographics, previous treatment, operative information, early follow-up were obtained from patients' medical records. Phone interviews conducted determine successful healing or recurrence requiring further treatment. Statistical analysis by Fisher's exact test. institutional board approved study.A total 42 (19 males; median age, 44 (range, 20-76) years) between 1999 2002. Three lost excluded study. Etiology cryptoglandular (n = 22), Crohn's disease 13), coloanal ileal pouch-anal anastomotic 4). Fistulas classified deep transsphincteric 33), superficial 1), supralevator 2), rectovaginal 3). Initially, most had "closure" fistula but recrudescence common. Durable only achieved 31 percent (12/39). Healing etiology 23 (5/22), (4/13), 75 (3/4; P 0.14). Success classification 33 (11/33), 0 (0/1), (0/2), (1/3; 1). rate no treatment 38 (8/21) vs. 22 (4/18) those whose previously ( 0.32). Eight underwent second one them healed (12.5 percent). Median successfully 26 months.Fibrin low recrudescences occurred within three months. However, given morbidity relative simplicity procedure, should still be considered first-line fistulas.