title: Long-term outlook after successful fibrin glue ablation of cryptoglandular transsphincteric fistula-in-ano.
abstract: OBJECTIVE
  Initial success rates for fibrin glue ablation of cryptoglandular transsphincteric fistulas have been disappointing. We examined long-term outcomes after initially successful fibrin glue ablation of cryptoglandular transsphincteric fistulas.
  
  
  METHODS
  Retrospective review identified 36 adult patients with cryptoglandular transsphincteric fistula Tisseel VH(R) fibrin glue ablation that was performed from May 2000 to March 2005. Fibrin glue ablations were performed under supervision of fellowship-trained colorectal surgeons. Follow-up interval was based on time until recurrence of fistula or time of last fistula-free evaluation.
  
  
  RESULTS
  Twenty-four men and 12 women patients had a mean age of 50 (range, 27-85) years. Twenty patients responded to initial fibrin glue ablation treatment. Two additional patients healed with secondary fibrin glue ablation. Sixty-six percent (22/33 patients) of cryptoglandular transsphincteric fistulas were closed at three months. Eleven patients failed fibrin glue ablation at a mean of 33 (range, 6-41) days. Seventeen of 22 short-term success patients (3 months) were available for long-term follow-up. Ninety-four percent (16/17 patients) remained healed at final long-term follow-up. The remaining patient recurred just before the six-month follow-up.
  
  
  CONCLUSIONS
  Despite the suboptimal early success rate of fibrin glue ablation for cryptoglandular transsphincteric fistulas, when a fistula does close for at least six months this appears to be a durable closure. A single patient recurred after appearing healed at the three-month check.
authors.affiliation: Rectal and Colon Surgery Inc, 3216 State Street, Erie, Pennsylvania, 16508, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Adams
authors.forename: Jonathan
authors.initials: J
authors.lastname: Yang
authors.forename: Laurie Ann
authors.initials: LA
authors.lastname: Kondylis
authors.forename: Philip D
authors.initials: PD
authors.lastname: Kondylis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005401:Fissure in Ano / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives