Glue Sealing Treatment

More recently, fibrin glue injection has also been proposed as an alternative to classical methods of surgical treatment for obtaining long-term healing of Crohn's anal fistulae [56]. The use of fibrin glues in the treatment of fistulae-in-ano has been described over the last 12 years. The results published on this subject report success rates of up to 85% (Table 2) [57, 63]. The series studied in the literature so far have included only a very small number of patients suffering from inflammatory diseases where this type of treatment gives rather poor success rates [58,60-63]. Several authors have therefore concluded that the existence of a fistula complicating CD is a predictive factor for failure of fibrin glue injection treatment. Vitton et al. included only CD patients with anoperineal fistula tracts in an original study [56]. After a long follow-up period of nearly 2 years, their report shows that more than half (57%) of the 14 patients treated with this method were still asymptomatic. The local fibrin glue injection method has the obvious advantage of avoiding sphincter complications. They concluded that, partly because autologous fibrin glue was used, which seems to be less effective than the heterologous form, the results published to date on this method have not been very encouraging when the patients were suffering from a chronic inflammatory intestinal disease.

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