Seton drainage and fibrin glue injection for complex anal fistulas.
OBJECTIVE
The study aimed to evaluate the efficacy of fibrin glue in the treatment of complex anal fistula.


METHODS
Thirty consecutive patients with a complex anal fistula underwent glue instillation after an 8 week period of seton drainage. Cure was defined as complete closure of any secondary opening, absence of fistula seepage, and no abscess formation.


RESULTS
The mean age of the patients (15 males) was 40.5 (range, 22.8-69.1) years. The mean duration of follow-up was 11.7 (range, 0.2-33.5) months. Complete closure of the fistula was achieved in 17 patients at 1 month but in two patients a delayed abscess occurred. At the end of follow-up, 15 (50%) patients were considered to have been cured. The success rate was no different in cases of Crohn's disease or when postoperative antibiotic therapy was given. There was, however, a significant difference in success following regional vs general anaesthesia (68.4 vs 18.2% success, P = 0.02).


CONCLUSIONS
Fibrin glue cured 50% of our first 30 patients, and regional anaesthesia was predictive of success.
de Parades
V
V
Proctologie médico-interventionnelle Groupe hospitalier Diaconesses - Croix Saint Simon, rue du Sergent Bauchat, Paris, France. proctologie@hopital-dcss.org
Far
H Safa
HS
Etienney
I
I
Zeitoun
J-D
JD
Atienza
P
P
Bauer
P
P
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004322:Drainage; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012003:Rectal Fistula / Q000601:surgery / Q000628:therapy*; D014014:Tissue Adhesives / Q000008:administration & dosage*; D055815:Young Adult
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives