Document Detail


The treatment of anal fistulas with biologically derived products: is innovation better than conventional surgical treatment? An update.
MedLine Citation:
PMID:  23207714     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
New technical approaches involving biologically derived products have been applied in the treatment for anal fistulas in order to avoid the risk of fecal incontinence. The aim of this review was to evaluate the scientific evidence present in the literature regarding these techniques. Trials comparing surgery (fistulotomy, advancement mucosal flap closure and placement of seton) versus fibrin glue, fistula plug or acellular dermal matrix were considered. In fibrin glue versus traditional surgical treatment the healing rate was higher in the surgery group, and the recurrence rate was lower in the traditional surgery group, but these results were not statistically relevant. In acellular dermal matrix (ADM) versus traditional surgical treatment the recurrence rate of fistulas was significantly lower in the ADM group, but non-significant differences were recorded in incontinence and anal deformity. Our review shows that there are no significant advantages of the new techniques involving biologically derived products. Further randomized controlled trials are needed.
Authors:
Roberto Cirocchi; Stefano Trastulli; Umberto Morelli; Jacopo Desiderio; Carlo Boselli; Amilcare Parisi; Giuseppe Noya
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  Techniques in coloproctology     Volume:  -     ISSN:  1128-045X     ISO Abbreviation:  Tech Coloproctol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9613614     Medline TA:  Tech Coloproctol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of General Surgery, St. Maria Hospital, University of Perugia, Via Tristano di Joannuccio, 05100, Terni, Italy.
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