Fibrin glue for all anal fistulas.

The aim of this study was to determine if a new sphincter muscle-sparing technique that uses fibrin glue was effective in closing all types of anal fistulas. All patients with anal fistulas who were seen by a single surgeon over a 2-year period were treated with fibrin glue. Six to 8 weeks after a seton was placed in the fistula tract, either autologous fibrin glue or commercially available fibrin sealant was used to close the fistula tract. Twenty patients were treated with a mean follow-up of 10 months. Etiology of the anal fistulas was as follows: cryptoglandular in 13, Crohn's disease in four, and miscellaneous in three. Fibrin glue closure of the anal fistula was successful initially in 15 patients (75%) and was successful after a second treatment in two additional patients, for an overall fibrin glue fistula closure rate of 85% (17 of 20). Functional results have remained excellent with no patient reporting any change in continence after treatment. Fibrin glue is simple and effective treatment for all anal fistulas with excellent functional results.