Ligation of Intersphincteric Fistula Tract Versus Cyanoacrylate Glue in One-Stage Management of High Transsphincteric Perianal Fistula
Ligation of Intersphincteric Fistula Tract Versus Cyanoacrylate Glue in One-Stage Management of High Transsphincteric Perianal Fistula: A Randomized Controlled Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
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.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: mohamed Ibrahim khald, Assistant lecturer
- Telefonnummer: +201061399219
- E-mail: mohamed.khald@med.asu.edu.eg
Studiesteder
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Cairo, Egypten
- Rekruttering
- Faculty of medicine ain shams university
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
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
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Aktiv komparator: 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.
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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.
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Eksperimentel: 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
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Cyanoacrylate adhesive (Glubran 2) is instilled into the fistula tract after curettage to achieve tract obliteration and promote fistula healing.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Complete Fistula Healing Rate
Tidsramme: 3 months post-operative
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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.
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3 months post-operative
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Fistula Recurrence Rate
Tidsramme: Up to 12 months post-operative
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Reappearance of discharge, abscess, or fistula tract confirmed clinically and/or by MRI after documented initial healing
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Up to 12 months post-operative
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Change in Fecal Continence
Tidsramme: up to 12 months post-operative
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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)
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up to 12 months post-operative
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Postoperative Wound Infection Rate
Tidsramme: Within 1 month post-operative
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Clinical signs of infection (erythema, purulent discharge, fever) requiring antibiotic treatment or drainage
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Within 1 month post-operative
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Postoperative Pain Intensity (Visual Analog Scale)
Tidsramme: 24 hours , 1 week and 2 weeks Postoperative
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Self-reported pain intensity will be assessed using the 10-point Visual Analog Scale, where 0 = no pain and 10 = worst pain.
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24 hours , 1 week and 2 weeks Postoperative
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Total Operative Time
Tidsramme: Intraoperative
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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.
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Intraoperative
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- FMASUGSMD148-9-2025
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
IPD-delingsadgangskriterier
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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