Mucosal advancement in the treatment of anal fistula

Aguilar, Pedro Serrano; Plasencia, Gustavo; Hardy, Thomas G.; Hartmann, Rene F.; Stewart, William R.

doi:10.1007/bf02554093

Cited by 155 publications

(100 citation statements)

References 3 publications

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“…By this time 63 consecutive outpatients with an anal fistula had been evaluated for eligibility, of whom 20 did not meet the inclusion criteria (Fig. 1). A total of 43 patients were randomized to either AFP (21) or ERAF (22). Five patients in the AFP group and six in the ERAF group did not receive the allocated intervention.…”

Section: Resultsmentioning

confidence: 99%

Randomized clinical trial of anal fistula plugversusendorectal advancement flap for the treatment of high cryptoglandular fistulain ano

Ortiz

Marzo

Ciga

et al. 2009

British Journal of Surgery

139

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Background:The aim of this randomized study was to compare the results of anal fistula plug and endorectal advancement flap in the treatment of high fistula in ano of cryptoglandular origin.Methods: Consecutive patients with high trans-sphincteric fistula in ano of cryptoglandular aetiology were randomized to treatment with either an anal fistula plug or endorectal advancement flap. Patients agreed to participate in a follow-up programme, which included scheduled visits at 2, 4, 8, 12 and 24 weeks and at 1 year after surgery. The primary endpoint was effectiveness in fistula healing. Recurrence was defined as the presence of an abscess arising in the same area, or obvious evidence of fistulation.Results: A large number of recurrences in the fistula plug group led to premature closure of the trial. After 1 year, fistula recurrence was noted in 12 of 15 patients treated with an anal fistula plug compared with two of 16 treated with an endorectal advancement flap (relative risk 6·40 (95 per cent confidence interval 1·70 to 23·97); P < 0·001). Conclusion:Contrary to other published studies, an anal fistula plug was associated with a low rate of fistula healing, particularly in patients with a history of fistula surgery.

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Section: Resultsmentioning

confidence: 99%

Randomized clinical trial of anal fistula plugversusendorectal advancement flap for the treatment of high cryptoglandular fistulain ano

Ortiz

Marzo

Ciga

et al. 2009

British Journal of Surgery

139

View full text Add to dashboard Cite

show abstract

“…The external opening remains open, allowing continued drainage as the tract heals. Variable success rates have been reported, reaching up to 90%, but more frequently between 60% and 71% (84)(85)(86)(87)(88)(89). Recurrence rates have been reported to be as high as 57% in CD patients (88).…”

Section: Resultsmentioning

confidence: 99%

“…Recurrence rates have been reported to be as high as 57% in CD patients (88). Incontinence, typically for liquid stool and gas, occurs at rates of about 8%-9% (84,87,88). The technically difficult nature of this operation coupled with the limited number of patients who are candidates for this procedure have limited its widespread use in patients with CD.…”

Section: Resultsmentioning

confidence: 99%

MR Imaging of Perianal Crohn Disease

et al. 2017

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“…Successful healing has been demonstrated in 55%-98% of patients submitted to the procedure. Although the sphincter mechanism is not divided during the construction of the endorectal flap, minor incontinence has been reported in up to 31% of the patients and major incontinence in up to 12% (2,12,16,21) . In this context, fibrin glue injection has emerged as an attractive sphincter-conserving treatment for anal fistula.…”

Section: Introductionmentioning

confidence: 99%

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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Mucosal advancement in the treatment of anal fistula

Cited by 155 publications

References 3 publications

Randomized clinical trial of anal fistula plugversusendorectal advancement flap for the treatment of high cryptoglandular fistulain ano

Randomized clinical trial of anal fistula plugversusendorectal advancement flap for the treatment of high cryptoglandular fistulain ano

MR Imaging of Perianal Crohn Disease

Fibrin glue in the management of complex anal fistula

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