Fibrin glue application in the treatment of recurrent anorectal fistulas.

PURPOSE: This prospective study was done to analyze the efficacy of autologous fibrin glue application in the healing or closure of recurrent anorectal fistulas. Autologous cryoprecipitate was used as fibrin glue in all patients. This group included complex anorectal fistulas, rectovaginal fistulas, and urethrovesicorectal fistulas.

METHODS: Patients were given bowel preparation and intravenous antibiotics before the procedure. Fistulas were curetted before injection of fibrin glue.

RESULTS: Overall success rate was 60 percent. Patients with fistulas associated with acquired immunodeficiency syndrome and the urinary tract failed to respond. No major complications were encountered.

CONCLUSION: The results of fibrin glue use in this small series of recurrent fistulas is appealing. This use of fibrin glue can be done as an outpatient procedure as a minimally invasive technique, without any significant complications. It can be offered as an alternative to conventional surgery in recurrent fistulas.