title: Long-term results of fibrin glue treatment for cryptogenic perianal fistulas: a multicenter study.
abstract: BACKGROUND
  Instillation of fibrin glue, a simple and safe procedure, has been shown to have a moderate short-term success rate in the treatment of cryptogenic perianal fistulas.
  
  
  OBJECTIVE
  This study aimed to assess the long-term outcome of this procedure.
  
  
  METHODS
  This study included a retrospective chart review and telephone interviews.
  
  
  METHODS
  This study was conducted at 4 university-affiliated medical centers.
  
  
  METHODS
  Patients were included who underwent fibrin glue instillation for complex cryptogenic fistula between 2002 and 2003 within a prospective trial and had successful healing.
  
  
  METHODS
  Fibrin glue was instilled for complex cryptogenic fistula.
  
  
  METHODS
  The main outcome measure was long-term fistula healing.
  
  
  RESULTS
  Sixty patients participated in the initial trial; the fistulas in 32 of these patients were healed at 6 months. We have located and interviewed 23 (72%) of those patients. Seventeen (74%) patients remained disease free at a mean follow-up of 6.5 years. Six (26%) patients had variable degrees of recurrence; 4 needed further surgical intervention and 2 were treated with antibiotics only. Recurrent disease occurred at an average of 4.1 years (range, 11 mo to 6 y) from surgery, and on several occasions was at a different location in the perianal region. None of the patients experienced incontinence following the procedure.
  
  
  CONCLUSIONS
  The retrospective nature of this long-term follow-up was a limitation. Twenty-eight percent of the potentially eligible patients were lost to long-term follow-up.
  
  
  CONCLUSIONS
  Short-term success of fibrin glue in the treatment of cryptogenic perianal fistula is predictive of long-term healing, but a quarter of those healed in the short term may develop recurrent symptoms in the long run. Injection of fibrin glue remains a safe and simple procedure and may preclude extensive surgery.
authors: Department of Surgery, Sheba Medical Center, Tel-Hashomer, Israel, affiliated to the Sackler School of Medicine, Tel Aviv, Israel.
authors: Nadav
authors: N
authors: Haim
authors: David
authors: D
authors: Neufeld
authors: Yehiel
authors: Y
authors: Ziv
authors: Hagit
authors: H
authors: Tulchinsky
authors: Moshe
authors: M
authors: Koller
authors: Marat
authors: M
authors: Khaikin
authors: Oded
authors: O
authors: Zmora
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives