Ligation of Intersphincteric Fistula Tract Versus Cyanoacrylate Glue in One-Stage Management of High Transsphincteric Perianal Fistula

August 2, 2026 updated by: Ain Shams University

Ligation of Intersphincteric Fistula Tract Versus Cyanoacrylate Glue in One-Stage Management of High Transsphincteric Perianal Fistula: A Randomized Controlled Trial

This study aims to compare ligation of the intersphincteric fistula tract with cyanoacrylate glue in the management of high transsphincteric perianal fistula.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a prospective randomized controlled trial comparing ligation of the intersphincteric fistula tract (LIFT) with cyanoacrylate glue (CAG) in the treatment of high transsphincteric perianal fistula.

Adult patients with MRI-confirmed disease will be randomly assigned in a 1:1 ratio to either technique.

The primary outcome is fistula healing , while secondary outcomes include operative time, postoperative pain, complications, recurrence, and continence.

This trial aims to determine the safer and more effective sphincter-preserving approach.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Egypt
      • Cairo, Egypt
        • Recruiting
        • Faculty of medicine ain shams university

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Age ≥ 16 years MRI-confirmed high transsphincteric perianal fistula Fit for surgery (ASA I-III)

Exclusion Criteria:

  • Crohn's disease
  • Tuberculosis or malignancy-associated fistula
  • Horseshoe fistula
  • Previous definitive fistula surgery (excluding drainage procedures)
  • Pregnancy
  • Immunocompromised state (e.g., HIV, chronic steroid use, chemotherapy)
  • Uncontrolled diabetes mellitus (HbA1c > 8% )
  • Active, undrained perianal sepsis/abscess at the time of scheduled surgery

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Ligation of the intersphincteric fistula tract
Patients in this arm will undergo ligation of the intersphincteric fistula tract as a sphincter-preserving surgical technique for the treatment of high transsphincteric perianal fistula.
Procedure: ligation of the intersphincteric fistula tract
Patients in this arm will undergo ligation of the intersphincteric fistula tract as a sphincter-preserving surgical technique for the treatment of high transsphincteric perianal fistula.
Experimental: Cyanoacrylate Glue (Glubran 2)
cyanoacrylate glue (Glubran 2) is instilled into the fistula tract after curettage to achieve tract obliteration and promote subsequent fistula healing
Procedure: Cyanoacrylate adhesive (Glubran 2)
Cyanoacrylate adhesive (Glubran 2) is instilled into the fistula tract after curettage to achieve tract obliteration and promote fistula healing.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Complete Fistula Healing Rate
Time Frame: 3 months post-operative
Complete epithelialization of the external opening, confirmed clinically and, where indicated, by MRI, with no discharge on gentle compression and no evidence of abscess or infection.
3 months post-operative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fistula Recurrence Rate
Time Frame: Up to 12 months post-operative
Reappearance of discharge, abscess, or fistula tract confirmed clinically and/or by MRI after documented initial healing
Up to 12 months post-operative
Change in Fecal Continence
Time Frame: up to 12 months post-operative
Change in continence status from baseline using Cleveland Clinic Florida Fecal Incontinence Score (Wexner Score) 0-20 , range 0 [perfect continence] to 20 [complete incontinence]; higher score = worse continence)
up to 12 months post-operative
Postoperative Wound Infection Rate
Time Frame: Within 1 month post-operative
Clinical signs of infection (erythema, purulent discharge, fever) requiring antibiotic treatment or drainage
Within 1 month post-operative
Postoperative Pain Intensity (Visual Analog Scale)
Time Frame: 24 hours , 1 week and 2 weeks Postoperative
Self-reported pain intensity will be assessed using the 10-point Visual Analog Scale, where 0 = no pain and 10 = worst pain.
24 hours , 1 week and 2 weeks Postoperative
Total Operative Time
Time Frame: Intraoperative
Operative time is defined as the time from initial surgical incision or fistula tract access to completion of the procedure, including tract ligation in the LIFT group and complete cyanoacrylate glue instillation in the cyanoacrylate group.
Intraoperative

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ain Shams University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 15, 2025

Primary Completion (Estimated)

April 14, 2027

Study Completion (Estimated)

April 20, 2027

Study Registration Dates

First Submitted

July 29, 2026

First Submitted That Met QC Criteria

August 2, 2026

First Posted (Actual)

August 4, 2026

Study Record Updates

Last Update Posted (Actual)

August 4, 2026

Last Update Submitted That Met QC Criteria

August 2, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FMASUGSMD148-9-2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified data for all participants will be shared, including information used to assess the main outcome (fistula healing) and secondary outcomes (operative time, pain after surgery, wound infection, recurrence, and continence score), along with basic demographic and clinical data.

IPD Sharing Time Frame

Data will be available beginning 6 months after publication of the primary results and will remain accessible for up to 3 years thereafter.

IPD Sharing Access Criteria

Access will be granted to qualified researchers who submit a methodologically sound proposal, upon signing a data access/use agreement with the corresponding author. Requests will be reviewed on a case-by-case basis and require approval from the Institutional Ethics Committee, Ain Shams University, prior to data release.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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