Abstract:
BACKGROUND :
Fistula in ano is amongst one of the earliest lesions to be recognized. It is accepted that
majority of them occur due to suppuration of anal glands which open into the anal
crypts. Fistula-in-Ano is the most common and an intriguing problem of the Ano-rectal
region in general population. Cyanoacrylate glue injection for fistula in ano is beneficial
as one of the modalities of treatment with respect to ease of applicability, cost
effectiveness ,less pain, sparing of sphincters, early recovery and low complications
compared to conventional procedures like fistulectomy.
OBJECTIVES: To compare the efficacy of cyanoacrylate glue versus conventional
fistulectomy in patients with fistula in ano with respect to
Post operative Pain
Perianal wound/scar
Duration of hospital stay
Maintenance of continence
Recurrence of fistula at 6 months follow-up time
Cost effectiveness of the procedure
MATERIAL AND METHODS:
Patients admitted with fistula in ano were allocated to study group (Cyanoacrylate glue
injection) and control group (Fistulectomy) alternatively.
Detailed history was taken, thorough clinical examination was done and
relevant investigations were performed for all the patients in both the study and
control groups.
A Proforma was used to collect all the relevant data from the patients both
preoperatively and post operatively. All cases were followed up to discharge and subsequently at 1st month, 3rd month
and 6th month.
RESULTS: Mean age for fistula in ano was found to be 35.8years , male is to female
ratio is 2:1 , Intersphicteric fistula is most common type of fistula,,there is significant
difference between mean pain score in patient treated with glue injection (1.3)and those
treated with fistulectomy(6.4).No complication was seen in patients treated with
cyanoacrylate glue injection where as patients treated with fistulectomy had
complications.Success rate of both procedures is about 90.2%.
CONCLUSION: Given its safety profile ,ease of application ,simplicity ,less
postoperative pain, reduced duration of hospital stay, early recovery , low complication
rate and post operative morbidity cyanoacrylate glue injection should be considered in the
management of fistula in ano and is better than fistulectomy in these aspects.
