DOI: http://dx.doi.org/10.18203/2349-2902.isj20191276

Efficacy of cyanoacrylate glue in anal fistulas

Santhosh Chikkanayakanahalli Shivashanka, Aruna Nayaka Nagaraja Nayaka, Mallikarjuna Manangi, Seshagiri Rao, Srinivas Nanjangud Masanashetty

Abstract


Background: Fistula in ano is a common problem. Surgical techniques such as fistulectomy, fistulotomy were associated with complications like excessive bleeding, infection, recurrence etc. The employment of cyano acrylate glue is one of the newer promising techniques. The aim of this study was to evaluate the efficacy of cyanoacrylate glue in the treatment of anal fistulas.

Methods: Study was conducted on patients with fistula-in-ano admitted to various surgical units in hospitals attached to Bangalore Medical College and Research Institute from November 2016 to May 2018. A total of 30 patients fulfilling the criteria were included in the study. Under spinal anesthesia, patients were posted for the procedure. Post operatively the patients were examined every 2 weeks for the first 2 months, and then once every 3 months. If the fistula failed to heal with primary treatment at a 4-week interval, a second glue treatment was performed. Post-treatment the success of the procedure was assessed by the incidence of infection and recurrence.

Results: Twenty two patients got healed with primary application with stoppage of any discharge from the fistulous track. Two patients required one more application, and one patient required fistulotomy. One patient developed complex fistulas and had to be treated with colostomy and fistulectomy. 4 patients developed purulent discharge after application of glue and were treated with IV antibiotics and healed completely.

Conclusions: Cyanoacrylate glue can be offered as a sphincter sparing alternative to fistulectomy in patients with anal fistulas.


Keywords


Anal fistula, Cyanoacrylate glue

Full Text:

PDF

References


Mazier WP. The treatment and care of anal fistulas: a study of 1000 patients. Dis Col and Rect. 1971;14:134-44.

Lunniss PJ, Kamm MA, Phillips RK. Factors affecting continence after surgery for anal fistula. Br J Surg. 1994;81:1382-5.

Sentovich SM. Fibrin glue for all anal fistulas. J Gastroint Surg. 2001;5:158-61.

Deeba S, Aziz O, Saine PS, Darzi A. Fistula in ano: advances in treatment. Am J Surg. 2008;196:95-9.

Jain SK, Kaza RCM, Pahwa M, Bansal S. Role of cyanoacrylate glue in the management of low fistula in ano: a prospective study. Int J Colorectal Dis. 2008;23:355-8.

Parks AG, Gardon PH, Hardcastle JD. A classification of fistula in ano. Br J Surg. 1976;63:1-12.

Bleier JI, Moloo H. Current management of cryptoglandular fistula in ano. World J Gastroenterol. 2011;17(28):3286-91.

Van Tets WF, Kuijpers HC. Continence disorders after anal fistulotomy. Dis Colon Rectum. 1994;37:1194-7.

Garcia-Aguilar J, Belmonte C, Wong WD, Goldberg SM, Madoff RD. Anal fistula surgery: factors associated with recurrence and incontinence. Dis Colon Rectum. 1996;39:723-9.

Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol. 2015;21(1):12-20.

Hammond TM, Grahn MF, Luniss PJ. Fibrin glue in the management of anal fistulae. Colorectal Dis. 2004;6(5):308-19.

Lindsey L, Smilgin-Humphreys MM, Cunningham C, Mortensen NJ, George B. A randomised, controlled trial of fibrin glue vs conventional treatment for anal fistula. Dis Colon Rectum. 2002;45:1608-15.

Cirocchi R, Santoro A, Trastulli S, Farinella E, Di Rocco G, Vendettuali D, et al. Meta-analysis of fibrin glue versus surgery for treatment of fistula-in-ano. Ann Ital Chir. 2010;81(5):349-56.

Barillari P, Basso L, Larcinese A, Gozzo P, Indinnimeo M. Cyanoacrylate glue in the treatment of ano-rectal fistulas. Int J Colorectal Dis. 2006;21(8):791-4.