Aim: This study was done to assess the efficacy and advantage of fibrin glue therapy in anal fistulae in comparison to conventional treatment. Patients and Method:The results of treatment of anal fistula by autologous fibrin tissue adhesive in 30 patients were compared with those obtained by conventional surgery in another 30 patients. All patients in both procedures had preoperative mechanical bowel preparations and preoperative intravenous antibiotic.The two groups were matched for age, sex, fistula type and follow-up duration. Results:The non-invasive fibrin glue application was extremely satisfactory in 24 patients out of 30 patients (80%), two healed after another attempt, three showed no postoperative improvement and one patient developed intersphincteric abscess (morbidity 3.3%). Median hospital stay was 1.5 days, while patients' discomfort was minimal. There was no postoperative impairment of anal sphincter function and there was no recurrence. In the group undergoing laying open operations, recurrence occurred in five patients, median hospital stay was 3.1 days, and strong analgesia was needed. Continence disorder occurred in four patients, one patient remained incontinent only for flatus, in two patients minimal soiling persists for more than three months followup. Conclusion:In conclusion, the above data showed that fibrin glue application in anal fistula is a simple, easy, safe, and effective procedure, although longer follow-up and bigger series are needed.

Aim:The aim of our study was to determine to what extent serial carcinoembryonic antigen (CEA) is helpful in detecting colorectal cancer recurrence. Second major objectives of this study were to evaluate tissue staining with CEA monoclonal antibody and its pattern of distribution in malignant tissue as regards its relation to prognostic value.Patients and Methods: 30 colorectal cancer patients undergoing clinically curative operations were studied. Primary tumors were evaluated for tissue CEA using immunohistochemical staining with CEA monoclonal antibody. Preoperative serum CEA level was measured as well as in follow-up monitoring of the patients. Results:The exact preoperative serum CEA value did not correlate with tumor stage, grade and immunohistochemical intensity or pattern. In the ten patients who developed recurrent cancer, the serum CEA at recurrence was greater than 5 ng/ml in 80%. All such patients with recurrent tumor had CEA present in their primary tumor.There was no correlation with exact preoperative serum CEA, the intensity of the primary tissue CEA, or localization of such CEA. Conclusion:Tissue CEA is a useful marker in prediction of tumor recurrence. Also serum CEA is a useful marker in detection of recurrent colorectal cancer. ZusammenfassungZielsetzung: Das Ziel unserer Untersuchung war die Bestimmung, inwieweit serienmäßiges karzinoembryonales Antigen (CEA) bei der Entdeckung von kolorektalen Karzinomrezidiven hilfreich ist. Die zweite große Zielsetzung dieser Untersuchung war die Bewertung von Gewebeeinfärbungen mit monoklonalen CEA-Antikörpern und ihrem Verteilungsmuster in malignem Gewebe im Hinblick auf ihren Voraussagewert.Patienten und Methoden: Wir untersuchten 30 Patienten mit kolorektalen Karzinomen, die sich klinisch kurativen Operationen unterzogen. Primärtumoren wurden im Hinblick auf das Gewebe-CEA mittels immunhistochemischer Einfärbungen mit monoklonalen CEA-Antikörpern bewertet. Die CEA-Serumspiegel wurden präoperativ ebenso gemessen wie bei den folgenden Nachuntersuchungen der Patienten.Ergebnisse: Die genauen präoperativen CEA-Serumwerte korrelierten nicht mit dem Tumorstadium, dem Tumorgrad und der immunhistochemischen Stärke oder dem Muster. Bei 80% der zehn Patienten, die ein Rezidiv entwickelten, war der CEA-Serumspiegel zum Rezidivzeitpunkt höher als 5 ng/ml. Bei allen Patienten mit einen Tumorrezidiv war zum Zeitpunkt des Primärtumors CEA vorhanden. Es bestand keine Korrelation mit dem genauen Serum-CEA, der Intensität des primären Gewebe-CEA oder der Lokalisation des CEA.Schlussfolgerung: Gewebe-CEA ist ein nützlicher Marker bei der Vorhersage eines Tumorrezidivs. Das Serum-CEA ist ebenfalls ein nützlicher Marker bei der Entdeckung von rezidivierenden kolorektalen Karzinomen.