A prospective study comparing the efficacy of cyanoacrylate glue injection versus conventional fistulectomy in management of patients with fistula in ano

Abstract

Background: Management of fistula in ano is challenging and debatable. Although various surgical techniques are described but none of them are free from complications like recurrence, pain, incontinence, delayed wound healing. Cyanoacrylate glue due to its excellent tissue gluing property is being used in variety of surgeries. Hence we intend to study and compare the efficacy of Cyanoacrylate glue injection verses fistulectomy in management of patients with fistula in ano. Material and Methods: From October 2017 - May 2019, 60 patients with fistula in ano were enrolled in the study. 30 patients were subjected to cyanoacrylate glue injection, and 30 patients underwent fistulectomy. All patients after clinical examination were subjected for MRI fistulogram before undergoing the procedure. Patients were followed up at 1 month, 3 months and 6 months following procedure. Results: Success rate after single application of glue was 90%.Mean duration of the procedure was around 15minutes. Mean pain score was 1.3, no glue associated complication was seen. None of them complained of incontinence. Mean duration of hospital stay was 1.2days. In patients treated with fistulectomy mean pain score was seen to be 6.4, mean duration of procedure was around 38.6minutes, two of the patients had wound infection, mean duration of hospital stay was 7.2days. Three patients with fistulectomy presented with recurrence, none of them had incontinence. Conclusion: Cyanoacrylate glue injection can be used as noninvasive,costeffective, sphincter saving technique as an alternative to fistulectomy.

Keywords

• fistulectomy
• fistula in ano
• cyanoacrylate glue