Management of Fistula in Ano with Biodegradable Glue vs Conventional Fistulectomy- A Comparative Study

Background: Fistula in ano is one of the common conditions that bring the patient to a surgery clinic.It is often difficult to manage because of its propensity for recurrence and post operative complications like incontinence. Aim:To compare conventional fistulectomy with cyanoacrylate glue in terms of post operative pain, mean hospital stay, incidence of incontinence and recurrence. Method:The study was a prospective, double blind, randomized study conducted in the department of general surgery, Ispat General Hospital, Rourkela.A total of 40 patients above 18 years and admitted for treatment of fistula in ano were included in this study.The data were collected in the post operative period and statistical analysis was done using SPSS 18.0 and R environment ver.3.2.2.P value <0.05 was considered significant.Result: All patients in the fistulectomy group needed analgesics in the post operative period compared to only 20% (4/20) patients in the glue group.The mean hospitalization duration was 7.1 ± 2.64 days and 1.45 ±0.49days in the fistulectomy group and glue group respectively.20% (4/20) of the patients developed major and 25% (5/20) developed minor incontinence in the fistulectomy group whereas no such complications seen in the glue group.The recurrence rate was 35% (7/20) and 25% (5/20) in the glue group and the fistulectomy group respectively.Conclusion: cyanoacrylate glue is a cost effective, safe and hence can be offered as an alternative to fistulectomy in patients with complex anal fistula where chances of sphincter damage following surgery is high.