Fibrin glue application in the treatment of recurrent anorectal fistulas
- 61 Downloads
PURPOSE: This prospective study was done to analyze the efficacy of autologous fibrin glue application in the healing or closure of recurrent anorectal fistulas. Autologous cryoprecipitate was used as fibrin glue in all patients. This group included complex anorectal fistulas, rectovaginal fistulas, and urethrovesicorectal fistulas. METHODS: Patients were given bowel preparation and intravenous antibiotics before the procedure. Fistulas were curetted before injection of fibrin glue. RESULTS: Overall success rate was 60 percent. Patients with fistulas associated with acquired immunodeficiency syndrome and the urinary tract failed to respond. No major complications were encountered. CONCLUSION: The results of fibrin glue use in this small series of recurrent fistulas is appealing. This use of fibrin glue can be done as an outpatient procedure as a minimally invasive technique, without any significant complications. It can be offered as an alternative to conventional surgery in recurrent fistulas.
Key wordsComplex recurrent anal fistulas Rectovaginal fistulas Autologous fibrin glue Cryoprecipitate
Unable to display preview. Download preview PDF.
- 1.Giardino R, Brulatti M, Franchini A. Colonic anastomoses protected with fibrin sealant: fibrin sealant in operative medicine. In: Schlag G, Redl H, eds. General surgeon and abdominal surgery. Berlin: Springer Verlag, 1986:155–7.Google Scholar
- 2.Cronkite ET, Lozner EL, Deaver JM. Use of thrombin and fibrinogen in skin grafting. JAMA 1944;124:976–8.Google Scholar
- 3.Matras H, Dinges HP, Lassmann H,et al. Suture-free interfascicular nerve transplantation in animal experiments[in German]. Wien Med Wochenschr 1972;122:517–23.Google Scholar
- 4.Matras H. Fibrin seal: the state of the art. J Oral Maxillofac Surg 1985;43:605–11.Google Scholar
- 5.Abel ME, Chiu YS, Russell TR, Volpe PA. Autologous fibrin glue in the treatment of rectovaginal and complex fistulas. Dis Colon Rectum 1993;36:447–9.Google Scholar
- 6.Lang AV, Meyer G, Wenk H,et al. Fistuloscopy—an adjuvant technique for sealing gastrointestinal fistulae. Surg Endosc 1990;4:212–6.Google Scholar
- 7.Hjortrup A, Moesgaard F, Kjäergard J. Fibrin adhesive in the treatment of perineal fistulas. Dis Colon Rectum 1991;34:752–4.Google Scholar