Treatment of Fistulas in ano with Fibrin Glue

BACKGROUND: Recent publications show promising results using fibrin glue in the treatment of anal fistulas. The technique is simple, repeatable, with minor surgical trauma so that sphincter function is preserved and further treatment options are not compromised. The aim of this pilot study was to analyse if we could reproduce the results reported in the literature, using this simple technique. METHODS: Patients with a primary or recurrent anal fistula were included in this trial. Patients with a complex fistula were excluded. Under general or spinal anaesthesia, the fistulas were curetted and injected with fibrin glue. Follow-up visits were scheduled for 1 week, 6 weeks and 6 months. RESULTS: Twenty-seven patients were included. The overall success rate was 33% after a mean follow-up of 27 weeks. Patients with a recurrent fistula had a poorer outcome (success rate 14%). None of the patients suffered from postoperative continence problems, and no other complications were recorded. CONCLUSION: This study confirms the safety of fibrin glue in the treatment of anal fistulas. However, a high success rate could not be reproduced.