A Randomized, Controlled Trial of Fibrin Glue vs. Conventional Treatment for Anal Fistula

Lindsey, Ian; Smilgin-Humphreys, M.; Cunningham, Chris; Mortensen, N. J. McC.; George, Bruce

doi:10.1007/s10350-004-7247-0

Cited by 245 publications

(173 citation statements)

References 30 publications

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“…The present study did not show any incidence of faecal or gas incontinence in any of the treated patients as also in all the similar studies, especially in the studies of El shobaky et al, [21], Zmora et al, [8] and Lindsey et al, [19].…”

Section: Resultssupporting

confidence: 85%

“…If a failure occurs after 1 attempt, then the patient should be offered various surgical options. In few studies, healing rates of 25% (Zmora et al, [8]) and 80% (Lindsey et al, [19] were noticed, after regluing, probably because of some technical flaws during the first attempt. If the technique is standardized and a learning curve is achieved, there should be no reason for a patient of fistula in ano, to have any different result after regluing as compared to that in the 1 st attempt.…”

Section: Resultsmentioning

confidence: 99%

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The Role of Fibrin Glue in the Treatment of High and Low Fistulas in Ano

Mishra¹

2013

JCDR

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Section: Resultssupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

The Role of Fibrin Glue in the Treatment of High and Low Fistulas in Ano

Mishra¹

2013

JCDR

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“…In contrast, other authors have achieved higher rates of success in treatment of cryptoglandular fistulas (1,13,19,23) . In the largest published series to date, CINTRON et al (4) reported a healing rate for cryptoglandular fistulas of 63%, compared with 35% for fistulas of other etiologies, with a mean follow-up of 1 year.…”

Section: Discussionmentioning

confidence: 56%

Fibrin glue in the management of complex anal fistula

Damin

Rosito

Contu

et al. 2009

Arq. Gastroenterol.

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-Context -Management of complex anal fistulas is associated with the risk of sphincter injury and fecal incontinence.In recent years, fibrin glue has emerged as an alternative sphincter-preserving treatment for anal fistulas. To date, however, there is no consensus about the efficacy of the method. Objective -To specifically evaluate the fibrin glue injection in the management of complex cryptoglandular anal fistulas. Methods -We studied a series of patients with complex anal fistulas treated with fibrin glue between January 2005 and January 2007. Only patients with fistulas of cryptoglandular origin were analyzed. Patients with fistulas related to Crohn's disease, HIV or previous surgery were excluded from the study. Under spinal anesthesia, the fistulas were curetted and injected with fibrin glue. After treatment, patients were followed-up for 12 months. Results -Thirty-two patients were enrolled in the study. Two patients were lost to follow-up and were excluded. Out of the remaining 30 patients, only three healed successfully (10%). Among the 27 patients who failed to heal, 9 (33.3%) were diagnosed within the first postoperative month. In 13 patients (48.1%) the failure of treatment occurred in the period between 1 and 3 months, in 3 patients (11.1%) between 3 and 6 months, and in 2 patients (7.4%) between 6 and 9 months after surgery. No treatment-related complications were observed. Conclusions -In this series, fibrin glue treatment for complex cryptoglandular anal fistulas achieved a very low healing rate. Our results do not support the use of fibrin glue as a first-line treatment for patients with this type of fistula. HEADINGS -Rectal fistula. Fibrin tissue adhesive. Tissue adhesives.

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“…On the other hand, some researchers reported that none of their patients developed anal incontinence [6,10,14,15].The small sample size is one of the limitations of some of these studies. Another limitation is the large number of low fistulae in both groups of patients because surgical treatment of a low fistula is unlikely to compromise continence and recurrence as recurrence is more common in high fistula.…”

Section: Discussionmentioning

confidence: 97%

Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

Saber¹

2016

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Abstract:Introduction: Anal fistulae are still negatively influencing the patient's quality of life by causing minor pain, social hygienic embarrassment, and in severe cases, frank sepsis. Although a number of surgical techniques have been proposed to treat this condition, there is still no single ideal technique for the treatment of this disease. Generally, fistulectomy is an adequate surgical procedure for the treatment of a simple or low transsphincteric fistula while others reported that fistulotomy continues to have excellent results. Patients and Methods: This study represented parallel prospective randomized clinical trial where 200 patients were divided randomly into two main groups; A and B. Group A patients were subjected to fistulotomy and those of group B were subjected to fistulectomy for low anal fistulae. The study included all patients having low anal fistulae complicating perianal abscesses. Patients with high fistulae and patients with multiple external openings were excluded. The primary end point was anal incontinence and the secondary end points were time off from work, postoperative pain, wound discharge, wound healing and patients' satisfaction. Results: The mean operative time, time taken for wound discharge to cease and time taken for complete healing was significantly less in patients of group A. Regarding the occurrence of fecal incontinence, no permanent cases were reported in our series but temporary incontinence was observed in 2 patients in fistulotomy group while in fistulectomy group there were 4 patients. Therefore, the overall patient satisfaction mean values were 90.6 ± 8.87and 85.6 ± 13.2 for patients in group A and B respectively with statistically insignificant distribution. Conclusion: Fistulotomy could be used as a primary treatment of low anal fistula as being safe and simple to perform with good patient's satisfaction as regard postoperative pain and outcome.

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A Randomized, Controlled Trial of Fibrin Glue vs. Conventional Treatment for Anal Fistula

Abstract: No advantage was found for fibrin glue over fistulotomy for simple fistulas, but fibrin glue healed more complex fistulas than conventional treatment and with higher patient satisfaction.

Cited by 245 publications

References 30 publications

The Role of Fibrin Glue in the Treatment of High and Low Fistulas in Ano

The Role of Fibrin Glue in the Treatment of High and Low Fistulas in Ano

Fibrin glue in the management of complex anal fistula

Patients Satisfaction and Outcome of Fistulotomy Versus Fistulectomy for Low Anal Fistula

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