title: Treatment of fistula in ano with fibrin glue: preliminary results from a prospective study.
abstract: OBJECTIVE
  This prospective study was done to evaluate the efficacy of commercial fibrin glue application in the healing of patients with fistulas-in-ano from a short follow up period (one year).
  
  
  METHODS
  This randomized clinical trial of 26 patients was performed during the period from January 2012 to July 2012. Nineteen men and seven women were treated for a fistula-in-ano with a commercial fibrin glue injection. In the operating room, the patients underwent an anorectal examination under spinal anesthesia. The external and internal fistula tract openings were then identified and the fistula tract was accurately curetted. Fibrin glue was introduced by a loaded double-channel syringe into the external fistula opening until the fibrin glue tip could be seen emerging from the internal opening.
  
  
  RESULTS
  The initial success rate was 76.9% (20/26). Recurrence rate was 23% (6/26). Four patients underwent a re-application of fibrin glue and the fistulas of these patients closed. Total recurrence rate was 7.6% (2/26). The overall success rate was 69.2% (18/26).
  
  
  CONCLUSIONS
  Fibrin glue application was thus found to be an easy, safe, successful alternative treatment in the management of fistulas-in-ano. Specifically, this therapeutic option demonstrated his efficacy for simple non-ramificated transsphincteric and intersphincteric fistulas. Multicentric randomized clinical trials with more representative sample seem to be necessary to investigate the best patients to treat by fibrin glue injection and the optimal application technique to improve these results.
authors.affiliation: Unit of General Specialistic and Mini‑invasive Surgery Federico II University of Naples, Naples, Italy - giovacestaro@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Cestaro
authors.forename: M
authors.initials: M
authors.lastname: De Rosa
authors.forename: M
authors.initials: M
authors.lastname: Gentile
mesh_terms: D000328:Adult; D003113:Colonoscopy; D003475:Curettage / Q000379:methods; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012003:Rectal Fistula / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D014014:Tissue Adhesives / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives