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Collagen treatment of complex anorectal fistula: 3 years follow-up

Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should be considered for complex fistulas. One of the...

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Autores principales: Maternini, Matteo, Guttadauro, Angelo, Avella, Pasquale, Buondonno, Antonio, Mascagni, Domenico, Milito, Giovanni, Stuto, Angelo, Renzi, Adolfo, Rennis, Maria, Bottini, Corrado, Quarto, Gennaro, Nudo, Raffaele, Del Re, Luca, Amato, Bruno, Gabrielli, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: De Gruyter 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350888/
https://www.ncbi.nlm.nih.gov/pubmed/37465352
http://dx.doi.org/10.1515/med-2022-0553
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author Maternini, Matteo
Guttadauro, Angelo
Avella, Pasquale
Buondonno, Antonio
Mascagni, Domenico
Milito, Giovanni
Stuto, Angelo
Renzi, Adolfo
Rennis, Maria
Bottini, Corrado
Quarto, Gennaro
Nudo, Raffaele
Del Re, Luca
Amato, Bruno
Gabrielli, Francesco
author_facet Maternini, Matteo
Guttadauro, Angelo
Avella, Pasquale
Buondonno, Antonio
Mascagni, Domenico
Milito, Giovanni
Stuto, Angelo
Renzi, Adolfo
Rennis, Maria
Bottini, Corrado
Quarto, Gennaro
Nudo, Raffaele
Del Re, Luca
Amato, Bruno
Gabrielli, Francesco
author_sort Maternini, Matteo
collection PubMed
description Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should be considered for complex fistulas. One of the sphincteric preserving treatment is the filling with a dermal extract commonly called “collagen glue” as Salvecoll-E(®) gel. This is a multicentric, prospective, observational study on the use of Salvecoll-E(®) gel in treatment of complex anal fistulas. We treated 70 patients from May 2016 to May 2017. In the first phase, we debrided the fistula tract using a loose seton kept for 4–6 weeks. In the second phase, the seton was removed and the fistula tract was filled with Salvecoll-E(®) gel. In this article, we report results at 36 months of follow-up. Fifty patients (71.4%) had completely healed fistula within 36 months of follow-up. Twenty-eight patients (28.2%) had recurrences. Among these failures, 65% were within 6 months. All low transphincteric fistulas healed. Recurrences occurred only in median and high transphincteric fistulas. No patient had a worsening of continence status measured with Cleveland Clinic Florida Incontinence Severity score. Salvecoll-E(®) gel is a recent finding among sphincter-sparing treatments. In this study, we demonstrate that it is a safe option in the treatment of complex fistulas. Final results are satisfactory and in line with the best results published in literature among mini-invasive treatments.
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spelling pubmed-103508882023-07-18 Collagen treatment of complex anorectal fistula: 3 years follow-up Maternini, Matteo Guttadauro, Angelo Avella, Pasquale Buondonno, Antonio Mascagni, Domenico Milito, Giovanni Stuto, Angelo Renzi, Adolfo Rennis, Maria Bottini, Corrado Quarto, Gennaro Nudo, Raffaele Del Re, Luca Amato, Bruno Gabrielli, Francesco Open Med (Wars) Research Article Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should be considered for complex fistulas. One of the sphincteric preserving treatment is the filling with a dermal extract commonly called “collagen glue” as Salvecoll-E(®) gel. This is a multicentric, prospective, observational study on the use of Salvecoll-E(®) gel in treatment of complex anal fistulas. We treated 70 patients from May 2016 to May 2017. In the first phase, we debrided the fistula tract using a loose seton kept for 4–6 weeks. In the second phase, the seton was removed and the fistula tract was filled with Salvecoll-E(®) gel. In this article, we report results at 36 months of follow-up. Fifty patients (71.4%) had completely healed fistula within 36 months of follow-up. Twenty-eight patients (28.2%) had recurrences. Among these failures, 65% were within 6 months. All low transphincteric fistulas healed. Recurrences occurred only in median and high transphincteric fistulas. No patient had a worsening of continence status measured with Cleveland Clinic Florida Incontinence Severity score. Salvecoll-E(®) gel is a recent finding among sphincter-sparing treatments. In this study, we demonstrate that it is a safe option in the treatment of complex fistulas. Final results are satisfactory and in line with the best results published in literature among mini-invasive treatments. De Gruyter 2023-07-11 /pmc/articles/PMC10350888/ /pubmed/37465352 http://dx.doi.org/10.1515/med-2022-0553 Text en © 2023 the author(s), published by De Gruyter https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License.
spellingShingle Research Article
Maternini, Matteo
Guttadauro, Angelo
Avella, Pasquale
Buondonno, Antonio
Mascagni, Domenico
Milito, Giovanni
Stuto, Angelo
Renzi, Adolfo
Rennis, Maria
Bottini, Corrado
Quarto, Gennaro
Nudo, Raffaele
Del Re, Luca
Amato, Bruno
Gabrielli, Francesco
Collagen treatment of complex anorectal fistula: 3 years follow-up
title Collagen treatment of complex anorectal fistula: 3 years follow-up
title_full Collagen treatment of complex anorectal fistula: 3 years follow-up
title_fullStr Collagen treatment of complex anorectal fistula: 3 years follow-up
title_full_unstemmed Collagen treatment of complex anorectal fistula: 3 years follow-up
title_short Collagen treatment of complex anorectal fistula: 3 years follow-up
title_sort collagen treatment of complex anorectal fistula: 3 years follow-up
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350888/
https://www.ncbi.nlm.nih.gov/pubmed/37465352
http://dx.doi.org/10.1515/med-2022-0553
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