O emprego da cola de fibrina no tratamento das fístulas anais

Lopes-Paulo, Francisco

doi:10.1590/s0101-98802006000100012

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…This treatment modality is appealing because it carries no risk of incontinence associated with division of sphincter muscles. It is safe and easy to perform, avoids open perineal wounds, and does not interfere with future surgical treatments if necessary (10,14) . The efficacy of the fibrin glue injection, however, remains in question.…”

Section: Discussionmentioning

confidence: 99%

“…However, because this treatment is safe and does not compromise future surgical treatments (14) , it might exceptionally have a limited role in selected very complex cases in which sphincter impairment is highly anticipated. In this situation, patients should be clearly warned about the low success rate expected with the procedure and the potential need of subsequent treatments.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fibrin glue in the management of complex anal fistula

Damin

Rosito

Contu

et al. 2009

Arq. Gastroenterol.

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“…Most patients with anal fistula may be treated surgically; however, more conservative conducts have been raised, but still presenting high rates of recurrence. Sealing fibrin or injections of buffer solution, for instance, present low rates of incontinence, but high relapse rates [19][20][21] . The postoperative sphincteric function, in the current study, has only been considered by patients' report, either spontaneously or by questioning, during the follow-up.…”

mentioning

confidence: 99%

Anal fistula: results of surgical treatment in a consecutive series of patients

Oliveira¹,

Sousa²,

Almeida³

et al. 2012

J. Coloproctol. (Rio J.)

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Objectives:To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. Methods: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. results: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. Conclusions: There was male prevalence (2.2/1), and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.Keywords: fistula; rectal fistula; surgery; classification; surgical treatment, operative. resuMO: Objetivos: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. Métodos: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. resultados: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto fistuloso, em 84,2% dos casos. A cicatrização completa ocorreu em todos os pacientes entre 2 e 16 semanas. Cento e setenta e oito pacientes, 84,8% dos pacientes operados, foram avaliados com, pelo menos, um ano de pós-operatório e a recidiva ocorreu em 6,4% dos casos. Conclusões: Houve prevalência do gênero masculino (2,2/1) com a maioria das fístulas transesfincterianas. A fistulotomia com marsupialização foi o tratamento operatório mais empregado e apresentou baixos índices de morbidade, com recidiva de 6,4%.

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Treatment of fistula-in-ano with cyanoacrylate glue with and without prior seton placement in rats

Romero

Santos²,

Cassino³

et al. 2016

Acta Cir. Bras.

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PURPOSE:To evaluate the efficacy of ethyl-cyanoacrylate in the treatment of fístula-in-ano in rats with and without prior seton placement. METHODS:Thirty rats Wistar with fístula-in-ano produced surgically, distributed in three groups: group A (ethyl-cyanoacrylate) -treated by application of ethyl-cyanoacrylate into fístula tract; group B (seton + ethyl-cyanoacrylate) -seton placement followed by application of ethyl-cyanoacrylate into fístula tract, 30 days later; group C (control) -no treatment. After 60 days the animals were submited to euthanasia and the specimens were analyzed by pathologist. The results were analyzed by Chi-square test with significant value of p<0.05. RESULTS:One animal of group B died. Were found tracts fully healed: 7, 5 and 2, in groups A, B and C, respectivelly. There was a statistically significant difference between groups A and C (p=0.02). When joined all animals treated with glue (A + B) compared to group C there was also statistically significant difference (p=0.02). CONCLUSIONS:The use of ethyl-cyanoacrylate glue was effective in closing anal fistulae in rats. There was no advantage in the prior application of seton.

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O emprego da cola de fibrina no tratamento das fístulas anais

Cited by 3 publications

References 6 publications

Fibrin glue in the management of complex anal fistula

Fibrin glue in the management of complex anal fistula

Anal fistula: results of surgical treatment in a consecutive series of patients

Treatment of fistula-in-ano with cyanoacrylate glue with and without prior seton placement in rats

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