Efficacy of synthetic glue treatment of high crypoglandular fistula-in-ano.

Abstract

OBJECTIVES:

In France, seton drainage followed by fistulotomy is currently the standard treatment for high cryptoglandular fistula-in-ano. Biological or synthetic glues, such as Glubran(®) 2, have been recently proposed for sealing the fistula tract. The purpose of this study is to determine the healing rate with glubran 2 and to assess the functional outcome after cure of fistula-in-ano.

PATIENTS AND METHODS:

From July 2006 to July 2008, 34 patients (20 males; median age 48.5 years, range 22-55 years) with high cryptoglandular anal fistulas were treated with glubran 2. Patients were seen for physical examination at 1, 3 and 6 months, then interviewed by telephone at 1 and 2 years, and in September 2009. The Fecal incontinence severity index (FISI) score was used to assess continence.

RESULTS:

The healing rate at 1 month was 67.6% (23 patients); the fistula failed to heal in 11 patients. All 23 patients with a healed fistula remained recurrence-free, with no continence disorders noted, during the median 34-month follow-up period (range 21-43 months). One patient was lost to follow-up after 6 months.

CONCLUSION:

Glubran 2 provides an effective treatment for high fistula-in-ano, with no change in continence. In future, a randomized comparison of this agent with fibrin glues should be useful.

• Authors: M Queralto, G Portier, G Bonnaud, J-P Chotard, P Cabarrot, F Lazorthes
• Journal: Gastroenterologie clinique et biologique (Gastroenterol Clin Biol) Vol. 34 Issue 8-9 Pg. 477-82 (Sep 2010) ISSN: 0399-8320 [Print] France
• PMID: 20674201 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Chemical References

• Cyanoacrylates
• Tissue Adhesives
• glubran 2

Topics

• Adult
• Aged
• Aged, 80 and over
• Cutaneous Fistula (surgery)
• Cyanoacrylates (adverse effects, therapeutic use)
• Fecal Incontinence (prevention & control)
• Female
• Humans
• Male
• Middle Aged
• Pain (etiology)
• Patient Preference
• Postoperative Complications (etiology)
• Rectal Fistula (surgery)
• Tissue Adhesives (adverse effects, therapeutic use)
• Treatment Outcome
• Young Adult