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International Journal of Colorectal Disease

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Open Access 01-07-2008 | Original Article

Fibrin glue and transanal rectal advancement flap for high transsphincteric perianal fistulas; is there any advantage?

Authors: Paul J. van Koperen, Jan Wind, Willem A. Bemelman, J. Frederik M. Slors

Published in: International Journal of Colorectal Disease | Issue 7/2008

Abstract

Backgrounds and aim

In recent decades, fibrin glue has appeared as an alternative treatment for high perianal fistulas. Early results seemed promising, with high success rates being reported. However, with increasing follow-up, the enthusiasm was tempered because of disappointing results. The aim of this retrospective study was to assess the additional value of fibrin glue in combination with transanal advancement flap, compared to advancement flap alone, for the treatment of high transsphincteric fistulas of cryptoglandular origin.

Materials and methods

Between January 1995 and January 2006, 127 patients were operated for high perianal fistulas with an advancement flap. After exclusion of patients with inflammatory bowel disease or HIV, 80 patients remained. A consecutive series of 26 patients had an advancement flap combined with obliteration of the fistula tract with fibrin glue. Patients were matched for prior fistula surgery, and the advancement was performed identically in all patients. In the fibrin glue group, glue was installed retrogradely in the fistula tract after the advancement was completed and the fistula tract had been curetted.

Results

Minimal follow-up after surgery was 13 months [median of 67 months (range, 13–127)]. The overall recurrence rate was 26% (n = 21). Recurrence rates for advancement flap alone vs the combination with glue were 13% vs 56% (p = 0.014) in the group without previous fistula surgery and 23% vs 41% (p = 0.216) in the group with previous fistula surgery.

Conclusion

Obliterating the fistula tract with fibrin glue was associated with worse outcome after rectal advancement flap for high perianal fistulas.

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Title: Fibrin glue and transanal rectal advancement flap for high transsphincteric perianal fistulas; is there any advantage?
Authors: Paul J. van Koperen
Jan Wind
Willem A. Bemelman
J. Frederik M. Slors
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 7/2008
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-008-0460-x

ACC 2024 Congress

Springer Medicine

Fibrin glue and transanal rectal advancement flap for high transsphincteric perianal fistulas; is there any advantage?

Abstract

Backgrounds and aim

Materials and methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Backgrounds and aim

Materials and methods

Results

Conclusion

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