Efficacy of synthetic glue treatment of high crypoglandular fistula-in-ano.
OBJECTIVE
In France, seton drainage followed by fistulotomy is currently the standard treatment for high cryptoglandular fistula-in-ano. Biological or synthetic glues, such as Glubran(®) 2, have been recently proposed for sealing the fistula tract. The purpose of this study is to determine the healing rate with glubran 2 and to assess the functional outcome after cure of fistula-in-ano.


METHODS
From July 2006 to July 2008, 34 patients (20 males; median age 48.5 years, range 22-55 years) with high cryptoglandular anal fistulas were treated with glubran 2. Patients were seen for physical examination at 1, 3 and 6 months, then interviewed by telephone at 1 and 2 years, and in September 2009. The Fecal incontinence severity index (FISI) score was used to assess continence.


RESULTS
The healing rate at 1 month was 67.6% (23 patients); the fistula failed to heal in 11 patients. All 23 patients with a healed fistula remained recurrence-free, with no continence disorders noted, during the median 34-month follow-up period (range 21-43 months). One patient was lost to follow-up after 6 months.


CONCLUSIONS
Glubran 2 provides an effective treatment for high fistula-in-ano, with no change in continence. In future, a randomized comparison of this agent with fibrin glues should be useful.
Queralto
M
M
Service de colo proctologie, clinique des Cèdres, Cornebarrieu, France. michel.queralto@wanadoo.fr
Portier
G
G
Bonnaud
G
G
Chotard
J-P
JP
Cabarrot
P
P
Lazorthes
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017577:Cutaneous Fistula / Q000601:surgery*; D003487:Cyanoacrylates / Q000009:adverse effects / Q000627:therapeutic use*; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D057240:Patient Preference; D011183:Postoperative Complications / Q000209:etiology; D012003:Rectal Fistula / Q000601:surgery*; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C421461:glubran 2