Long-term results of fibrin glue treatment for cryptogenic perianal fistulas: a multicenter study.
Dis Colon Rectum
; 54(10): 1279-83, 2011 Oct.
Article
in En
| MEDLINE
| ID: mdl-21904143
ABSTRACT
BACKGROUND:
Instillation of fibrin glue, a simple and safe procedure, has been shown to have a moderate short-term success rate in the treatment of cryptogenic perianal fistulas.OBJECTIVE:
This study aimed to assess the long-term outcome of this procedure.DESIGN:
This study included a retrospective chart review and telephone interviews. SETTINGS This study was conducted at 4 university-affiliated medical centers. PATIENTS Patients were included who underwent fibrin glue instillation for complex cryptogenic fistula between 2002 and 2003 within a prospective trial and had successful healing.INTERVENTIONS:
Fibrin glue was instilled for complex cryptogenic fistula. MAIN OUTCOMEMEASURES:
The main outcome measure was long-term fistula healing.RESULTS:
Sixty patients participated in the initial trial; the fistulas in 32 of these patients were healed at 6 months. We have located and interviewed 23 (72%) of those patients. Seventeen (74%) patients remained disease free at a mean follow-up of 6.5 years. Six (26%) patients had variable degrees of recurrence; 4 needed further surgical intervention and 2 were treated with antibiotics only. Recurrent disease occurred at an average of 4.1 years (range, 11 mo to 6 y) from surgery, and on several occasions was at a different location in the perianal region. None of the patients experienced incontinence following the procedure.LIMITATIONS:
The retrospective nature of this long-term follow-up was a limitation. Twenty-eight percent of the potentially eligible patients were lost to long-term follow-up.CONCLUSIONS:
Short-term success of fibrin glue in the treatment of cryptogenic perianal fistula is predictive of long-term healing, but a quarter of those healed in the short term may develop recurrent symptoms in the long run. Injection of fibrin glue remains a safe and simple procedure and may preclude extensive surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Adhesives
/
Fibrin Tissue Adhesive
/
Rectal Fistula
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Dis Colon Rectum
Year:
2011
Document type:
Article
Affiliation country:
Israel