Efficacy of Fibrin Sealant in the Management of Complex Anal Fistula

Buchanan, G. N.; Bartram, Clive I.; Phillips, R. K. S.; Gould, Stuart; Halligan, Steve; Rockall, Tim; Sibbons, Paul; Cohen, Richard G.

doi:10.1007/s10350-004-6708-9

Cited by 238 publications

(182 citation statements)

References 24 publications

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“…This procedure is technically demanding and may affect continence [7] . Use of fibrin glue is an alternative to the MAF; however, the long-term closure rates are low [8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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AIM:To investigate the efficacy of the anal fistula plug (AFP) compared to the mucosa advancement flap (MAF), considered the best procedure for patients with a complex anal fistula. METHODS:The literature search included PubMed, EMBASE, Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011. Randomized controlled trials, controlled clinical trials and prospective cohort studies were included in the review. After information collection, a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity. The quality of postoperative life was also included with the clinical results. RESULTS:Six studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 -0.14; RD = 0.13; 95%CI: -0.18 -0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 --0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 --0.00). The postoperative quality of life, for patients treated using the AFP was superior to that of the MAF patients. Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced. CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula; it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life. Additional evidence is needed to confirm these findings.

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“…This procedure is technically demanding and may affect continence [7] . Use of fibrin glue is an alternative to the MAF; however, the long-term closure rates are low [8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Jin²

2012

WJGS

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“…Various techniques have been described including fistulotomy [1][2][3][4], fistulectomy [5] and advancement flap procedures [6][7][8][9][10][11]. The results of fibrin glue treatment have been disappointing and the technique has largely been abandoned [12]. Furthermore, treatment is changing, the introduction of the fistula plug has had initial satisfactory results [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Incontinence rates after cutting seton treatment for anal fistula

2009

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Objective To determine the incidence of anal incontinence after the use of cutting seton treatment for anal fistula.Method Literature searches were performed on PubMed, MEDLINE and Google Ô Scholar using the words 'cutting seton(s)', 'seton(s)' and 'anal fistula'. An analysis of the data in the collected references was performed.Results The average rate of incontinence following cutting seton use was 12%. The rate of incontinence increased as the location of the internal opening of the fistula moved more proximally. In the studies that described the types of incontinence, liquid stool was the most common followed closely by flatus incontinence. Incontinence associated with the treatment of fistulas defined as nonspecific cryptoglandular in nature was 18%.Conclusion The high incontinence rates that result from the use of cutting setons suggest that this commonly used therapy can damage the continence musculature. Other techniques that do not involve cutting the sphincter, when available, should be preferred, especially for higher fistulas.

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“…Of the newer methods being tried VAAFTvideo assisted anal fistula treatment is showing promising results. 3,4 VAAFT can be used both for diagnostic and therapeutic purpose. This procedure doesn't involve tissue cutting and laying open of tract.…”

Section: Introductionmentioning

confidence: 99%

VAAFT versus fistulectomy in the management of anorectal fistulae: a comparative study?

Venkatapuram

Sateesh

2017

Int Surg J

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Background: Among the perianal diseases Fistula in ano is a very common condition bringing lot of discomfort to the patient with a high rate of recurrence as well. Conventionally fistulectomy has been the treatment of choice for fistula-in-ano. But the procedure is associated with lot of recurrence, morbidity and sphincter incontinence. Among several recent procedures VAAFT-video assisted anal fistula treatment is gaining popularity. So, we conducted this study to know the effectiveness of VAAFT over conventional fistulectomy. Methods: This prospective comparative study was undertaken to compare VAAFT and fistulectomy in the management of fistula-in-ano. A one-year study was carried out on 50 patients from mid-2015 to 2016. A visual analogue scale (VAS) was used to assess pain in the postoperative period. All patients were observed for one-year period for any recurrence of disease. Results were statistically analysed by SPSS 15.0 software. Results: two groups were formed among the 50 patients selected for study. There was male preponderance in both the groups. majority of patients belonged to 31-40 years of age group. Majority of the patients had low anal fistulae followed by patients with high anal fistulae and anorectal fistulae in that order. There was recurrence of disease in 12% of people operated by fistulectomy whereas it was only 1% in group who underwent VAAFT. Conclusions: VAAFT procedure offered significantly less recurrence rates in comparison with fistulectomy. There was less postoperative pain and nil complications after surgery. Patient satisfaction was high. Our study concluded VAAFT as a safe and effective procedure alternative to conventional fistulectomy.

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Efficacy of Fibrin Sealant in the Management of Complex Anal Fistula

Abstract: The success rate of fibrin glue application for complex anorectal fistulas without extension is 14 percent. Magnetic resonance imaging predicts outcome at an earlier stage than clinical examination.

Cited by 238 publications

References 24 publications

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Anal fistula plug vs mucosa advancement flap in complex fistula-in-ano: A meta-analysis

Incontinence rates after cutting seton treatment for anal fistula

VAAFT versus fistulectomy in the management of anorectal fistulae: a comparative study?

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