Fibrin glue in the management of anal fistulae
- 27 August 2004
- journal article
- research article
- Published by Wiley in Colorectal Disease
- Vol. 6 (5), 308-319
- https://doi.org/10.1111/j.1463-1318.2004.00676.x
Abstract
Fibrin glue has been used as a sphincter sparing approach for the treatment of anal fistulae for two decades. However, there is uncertainty about its short and long-term efficacy. The objective of this review was to ascertain the role of fibrin glue in the management of anal fistulae, including assessment of recurrence rates, continence disturbance and other complications. We searched Medline (January 1966 to February 2004), the Cochrane database, and EMBASE using the terms anal fistulae, fistula-in-ano, and fibrin glue. Relevant papers from the reference lists of these articles and from the authors' personal collections were also reviewed. A systematic review of all articles relating to the use of fibrin glue in the treatment of anal fistulae was performed. This included 19 studies. Reviewers performed data extraction independently. Outcomes evaluated included recurrence rates, continence disturbance, septic complications, adverse drug reactions, and duration of follow-up. Heterogeneity of the clinical trials made direct comparisons difficult and meta-analysis impossible. The success rates reported in published studies range from 0% to 100%. Differences in patient selection (including fistula aetiology and type), treatment protocols, and follow-up duration may contribute to such diverse results. Fibrin glue is simple to use, has a minimal morbidity and should not affect later treatment options in the event of its failure. It is therefore theoretically attractive as a first line treatment in the management of those types of anal fistula in which it has been shown to work. However, further research into 'biological' glues is merited and these subject to randomised controlled study.Keywords
This publication has 47 references indexed in Scilit:
- Fibrin glue for all anal fistulasJournal of Gastrointestinal Surgery, 2001
- Repair of fistulas-in-ano using fibrin adhesiveDiseases of the Colon & Rectum, 2000
- Fibrin Glue-Antibiotic Mixture in the Treatment of Anal Fistulae: Experience with 69 CasesDigestive Surgery, 2000
- Long-term analysis of the use of transanal rectal advancement flaps for complicated anorectal/vaginal fistulasDiseases of the Colon & Rectum, 1996
- Autologous fibrin glue in the treatment of rectovaginal and complex fistulasDiseases of the Colon & Rectum, 1993
- Prospective randomized trial comparing anal function after hand sewn ileoanal anastomosis with mucosectomyversus stapled ileoanal anastomosis without mucosectomy in restorative proctocolectomyBritish Journal of Surgery, 1991
- WarningJournal Of Trauma-Injury Infection and Critical Care, 1991
- Closure of the internal opening for treatment of complex fistula-in-anoDiseases of the Colon & Rectum, 1988
- Bacterial Lysis of Fibrin Seal in vitroEuropean Surgical Research, 1988
- Sliding flap advancement for the treatment of high level fistulaeBritish Journal of Surgery, 1987