Treatment of perianal fistulae with fibrin sealant

Background: The surgical management of high perianal fistula is associated with the risk of sphincter injury. Injection of fibrin sealant in the fistula tract is a simple procedure in an attempt to avoid more radical surgical intervention .
Objective: The purpose of this study was to evaluate the effects of fibrin sealant in treatment of high perianal fistula.
Method: Between October 2006 to December 2009, only patients with high perianal fistulae were included in this study. Injection of fibrin sealant into the fistulous tract under anesthesia was done. Patients were actively followed up at two weeks, one, two, six months and one year.
Results: The study included a total of 16 patients, 12 males (74.5%) and 4 females (25.5%), the age ranging from 32 to 55 years, the mean age 43.2 years. The type of fistulae as delineated by ultrasound were 10 intersphincteric (62.5%) and 6 transphincteric (37.5%). The success rate was 50%, the success rate among intersphincteric type of fistula was 60% and the transphincteric type was 34%. No complications were reported in our study.
Conclusion: Fibrin sealant injection was a useful treatment alternative in the treatment of perianal fistula. It may potentially preclude more extensive surgery in more than one half of patients. Further study should be designed to define predictors of success for better patient selection.