Abstract
The use of glue or paste as a sealant for anal fistula is an attractive treatment concept, as it can effect closure without jeopardizing fecal continence or interfering with potential future interventions. Multiple substances have been explored in the past, with fibrin glue and collagen paste being the most recent. This chapter presents the findings of non-randomized controlled studies with ≥25 patients and available randomized controlled trials. Evidence for the clinical effectiveness of fistula closure with fibrin glue is low; for collagen paste, data are even fewer. Available information is heterogeneous with regard to indication, outcome monitoring, and assessment. Study methodology varies widely. Randomized trials with fibrin glue indicate that the clinical benefit is limited. Despite this, the therapeutic concept of fistula closure with glue and paste remains of interest because of its very low invasiveness.
Similar content being viewed by others
References
Abel ME, Chiu YS, Russell TR et al (1993) Autologous fibrin glue in the treatment of rectovaginal and complex fistulas. Dis Colon Rectum 36:447–449
Adams T, Yang J, Kondylis LA et al (2008) Long-term outlook after successful fibrin glue ablation of cryptoglandular transsphincteric fistula-in-ano. Dis Colon Rectum 51:1488–1490
Altomare DF, Greco VJ, Tricomi N (2010) Seton or glue for trans-sphincteric anal fistulae: a prospective randomized crossover clinical trial. Color Dis 13:82–86
Amato A, Bottini C, Nardi D et al (2015) Italian society of colorectal surgery. Evaluation and management of perianal abscess and anal fistula: a consensus statement developed by the Italian Society of Colorectal Surgery (SICCR). Tech Coloproctol 19:595–606
Barillari P, Basso L, Larcinese A et al (2006) Cyanoacrylate glue in the treatment of ano-rectal fistulas. Int J Color Dis 21:791–794
Bayrak M, Altıntas Y (2018) Permacol™ collagen paste injection in anal fistula treatment: a retrospective study with one-year follow-up. Adv Ther 35:1232–1238
Brunner M, Schneider I, Günther K et al (2019) Permacol™ collagen paste for cryptoglandular and Crohn’s anal fistula. Tech Coloproctol 23:135–141
Cestaro G, De Rosa M, Gentile M (2014) Treatment of fistula in ano with fibrin glue: preliminary results from a prospective study. Minerva Chir 69:225–228
Cheung XC, FaheyT AC, Rogers CR et al (2021) Surgical management of idiopathic perianal fistulas: a systematic review and meta-analysis. Dig Surg 38:104–119
Cintron JR, Park JJ, Orsay CP et al (1999) Repair of fistulas-in-ano using autologous fibrin tissue adhesive. Dis Colon Rectum 42:607–613
Cintron JR, Park JJ, Orsay CP et al (2000) Repair of fistulas-in-ano using fibrin adhesive: long-term followup. Dis Colon Rectum 43:944–949
de la Portilla F (2008) Evaluation of the use of BioGlue in the treatment of high anal fistulas: preliminary results of a pilot study: the author replies. Dis Colon Rectum 51:1156
de la Portilla F, Muñoz-Cruzado MVD, Maestre MV et al (2019) Platelet-rich plasma (PRP) versus fibrin glue in cryptogenic fistula-in-ano: a phase III single-center, randomized, double-blind trial. Int J Color Dis 34:1113–1119
de Oca J, Millan M, Jimenez A et al (2011) Long-term results of surgery plus fibrin sealant for anal fistula. Color Dis 14:e12–e15
de Parades V, Far HS, Etienney I et al (2010) Seton drainage and fibrin glue injection for complex anal fistulas. Color Dis 12:459–463
Ellis CN, Clark S (2006) Fibrin glue as an adjunct to flap repair of anal fistulas: a randomized, controlled study. Dis Colon Rectum 49:1736–1740
Garcia-Arranz M, Garcia-Olmo D, Herreros MD et al (2020) Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: A randomized clinical trial with long-term follow-up. Stem Cells Transl Med 9:295–301
Garcia-Olmo D, Herreros D, Pascual I et al (2009) Expanded adipose-derived stem cells for the treatment of complex perianal fistula: a phase II clinical trial. Dis Colon Rectum 52:79–86
Giordano P, Sileri P, Buntzen S et al (2018) Final results of a European, multicentre, prospective, observational study of Permacol™ collagen paste injection for the treatment of anal fistula. Color Dis 20:243–251
Gisbertz SS, Sosef MN, Festen S et al (2005) Treatment of fistulas in ano with fibrin glue. Dig Surg 22:91–94
Hammond TM, Porrett T, Scott SM et al (2010) Management of idiopathic anal fistula using cross-linked collagen: a prospective phase 1 study. Color Dis 13:94–104
Herreros MD, Garcia-Arranz M, Guadalajara H et al (2012) Autologous expanded adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistulas: a phase III randomized clinical trial (FATT 1: Fistula Advanced Therapy Trial 1) and long- term evaluation. Dis Colon Rectum 55:762–772
Hjortrup A, Moesgaard F, Kjaergard J (1991) Fibrin adhesive in the treatment of perianal fistulas. Dis Colon Rectum 34:752–754
Jain SK, Kaza RCM, Pahwa M et al (2008) Role of cyanoacrylate in the management of low fistula in ano: a prospective study. Int J Color Dis 23:255–358
Johnson EK, Gaw JU, Armstrong DN (2006) The comparison of fibrin glue and fistula plug application efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum 49:371–376
Jurczak F, Laridon JY, Raggaitin P et al (2004) Biological fibrin used in anal fistulas: 31 patients. Ann Chir 129:286–289
Kontovounisios C, Tekkis P, Tan E et al (2016) Adoption and success rates of perineal procedures for fistula-in-ano: a systematic review. Color Dis 18:441–458
Lindsey I, Smilgin-Humphreys MM, Cunningham C et al (2002) A randomized, controlled trial of fibrin glue vs. conventional treatment for anal fistula. Dis Colon Rectum 45:1608–1615
Maralcan G, Baskonus I, Aybasti N et al (2006) The use of fibrin glue in the treatment of fistula-in-ano: a prospective study. Surg Today 36:166–170
Maralcan G, Baskonus I, Gökalp A et al (2011) Long-term results in the treatment of fistula-in-ano with fibrin glue: a prospective study. J Korean Surg Soc 81:169–175
Maternini M, Guttadauro A, Mascagni D et al (2020) Non cross-linked equine collagen (Salvecoll-E gel) for treatment of complex ano-rectal fistula. Asian J Surg 43:401–404
Mishra A, Shah S, Nar A et al (2013) The role of fibrin glue in the treatment of high and low fistulas in ano. J Clin Diagn Res 7:876–879
Ommer A, Herold A, Berg E (2017) German S3 guidelines: anal abscess and fistula (second revised version). Langenbeck’s Arch Surg 402:191–201
Park JJ, Cintron JR, Orsay CP et al (2000) Repair of chronic anorectal fistulae using commercial fibrin sealant. Arch Surg 135:166–169
Patrlj L, Kocman B, Martinac M et al (2000) Fibrin glue-antibiotic mixture in the treatment of anal fistulae: experience with 69 cases. Dig Surg 17:77–80
Queralto M, Portier G, Bonnaud G et al (2010) Efficacy of synthetic glue treatment of high crypoglandular fistula-in-ano. Gastroenterol Clin Biol 34:477–482
Schiano di Visconte M, Braini A, Moras L et al (2019) Permacol collagen paste injection for treatment of complex cryptoglandular anal fistulas: an observational cohort study with a 2-year follow-up. Surg Innov 26:168–179
Sentovich SM (2001) Fibrin glue for all anal fistulas. J Gastrointest Surg 5:158–161
Singer M, Cintron J, Neldson R et al (2005) Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or surgical closure of the internal fistula opening. Dis Colon Rectum 48:799–808
Tyler KM, Aarons CB, Sentovich SM (2007) Successful sphincter-sparing surgery for all anal fistulas. Dis Colon Rectum 50:1535–1539
van der Hagen SJ, Baeten CG, Soeters PB et al (2011) Staged mucosal advancement flap versus staged fibrin sealant in the treatment of complex perianal fistulas. Gastroenterol Res Pract:186350
van Koperen PJ, Wind J, Bemelman WA et al (2008) Fibrin glue and transanal rectal advancement flap for high transsphincteric perianal fistulas; is there any advantage? Int J Color Dis 23:697–701
Vollebregt PF, Vander Mijnsbrugge GJ, Molenaar CBH et al (2021) Efficacy of Permacol injection for perianal fistulas in a tertiary referral population: poor outcome in patients with complex fistulas. Color Dis 23:2119–2126
Witte ME, Klaase JM, Gerritsen JJ et al (2007) Fibrin glue treatment for simple and complex anal fistulas. Hepato-Gastroenterology 54:1071–1073
Yeung JMC, Simpson JA, Tang S-W et al (2010) Fibrin glue for the treatment of fistulae in ano – a method worth sticking to? Color Dis 12:363–366
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Matzel, K.E., Bittorf, B. (2022). Anal Fistula: Glue and Paste Injection. In: Ratto, C., Parello, A., Litta, F., De Simone, V., Campennì, P. (eds) Anal Fistula and Abscess. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-030-30902-2_26-1
Download citation
DOI: https://doi.org/10.1007/978-3-030-30902-2_26-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-30902-2
Online ISBN: 978-3-030-30902-2
eBook Packages: Springer Reference MedicineReference Module Medicine