Surgical treatment of perianal fistulas frequently affects fecal continence. Sphincter saving
techniques like loose or cutting seton and fistulectomy with advancement of an endorectal
flap have been advocated to minimize the risk of sphincter injury, but patients often
complain of a prolonged healing period and major discomfort. Furthermore, the healing rate
varies widely according to the type of fistula and the surgeon's experience.In the early '90s
the treatment of perianal fistulas by autologous or commercial fibrin glue was suggested and
the American FDA approved the use and marketing of a human fibrin glue in 1998.
Since then, several studies have evaluated the effectiveness of human fibrin glue in the
treatment of different types of perianal fistulas, reporting a wide range of success rates
ranging from 31 to 85%.
Primary aim of this study is to conduct a prospective randomized trial evaluating the
effectiveness of glue treatment of perianal fistulas as compared with the classical seton
treatment. Secondary aims are to compare postoperative faecal incontinence, postoperative
anal pain, healing time and length of hospitalization.