Fibrin glue treatment for simple and complex anal fistulas

Hepatogastroenterology. 2007 Jun;54(76):1071-3.


Background/aims: Surgical management of anal fistulas is associated with considerable morbidity, mainly related to anal sphincter injury. However, treatment with fibrin glue is a safe and simple method associated with less discomfort and complications. A prospective trial was conducted at our institute to evaluate the use of fibrin glue (Tissucol, Baxter, The Netherlands) for simple and complex anal fistulas.

Methodology: From November 2001 until March 2004, 34 patients (22 male, 12 female, median age 40 years) were treated with Tissucol. Twenty-three (67%) fistulas were classified as simple (subcutaneous, intersphincteric and transsphincteric) and 11 (33%) as complex (suprasphincteric, extrasphincteric and/or associated with Crohn's disease, ulcerative colitis or HIV).

Results: Twenty-six patients were treated once, 5 patients were treated twice, 2 patients were treated 3 times and 1 patient underwent 4 Tissucol treatments. After a median follow-up of 7 months, 13 of 23 simple fistulas (56%) and 6 out of 11 complex fistulas (54%) healed, accounting for an overall closure rate of 55%. Complications occurred in two patients, who both developed a perineal abscess after glue instillation.

Conclusions: Fibrin glue treatment is safe and effective in 55% of the patients with anal fistulas. It is a good alternative to conventional surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Female
  • Fibrin Tissue Adhesive / therapeutic use*
  • Humans
  • Male
  • Prospective Studies
  • Rectal Fistula / drug therapy*
  • Tissue Adhesives / therapeutic use*
  • Treatment Outcome


  • Fibrin Tissue Adhesive
  • Tissue Adhesives