SynthesisInternational journal of colorectal disease2015
Systematic review and meta-analysis of surgical interventions for high cryptoglandular perianal fistula.
Synthesis in International journal of colorectal disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05263661 (Ligation of Intersphincteric Fistula Tract Versus Rectal Advancement Flap in the Treatment of Complex Anal Fistula), which is not on this map. Cited by 35 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Ligation of Intersphincteric Fistula Tract Versus Rectal Advancement Flap in the Treatment of Complex Anal Fistula: Randomised Clinical Trial
Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Mesenchymal stem cells transplantation for perianal fistulas: a systematic review and meta-analysis of clinical trials.Stem cell research & therapy · 2023Pooled it
- Heterogeneity in outcome selection, definition and measurement in studies assessing the treatment of cryptoglandular anal fistula: findings from a systematic review.Techniques in coloproctology · 2021Pooled it
- Evaluation and management of perianal abscess and anal fistula: SICCR position statement.Techniques in coloproctology · 2020Guideline
- German S3 guidelines: anal abscess and fistula (second revised version).Langenbeck's archives of surgery · 2017Pooled it
- Microsurgery in mucosal advancement flap repair: a microscope-assisted, tissue-sparing approach for managing complex perianal fistulas within the IDEAL Stage 1 framework.Surgical endoscopy · 2026Trial
- The novel BioHealx®assisted fistula treatment (BAFT): effective primary fistula healing with continence preservation.International journal of colorectal disease · 2025Trial
- A Disposable Nitinol Memory Alloy Anal Fistula Clip (AFC) for the Treatment of Cryptoglandular Fistula-In-Ano: a Prospective, Randomized, Controlled Study With Short-Term Follow-Up.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Trial
- Ischiorectal abscess with fistulization into the thigh, the 'perfect storm' patient.Journal of surgical case reports · 2026Article
- Long anal fistulas might be simple fistulas beyond Goodsall's rule: a case series.BMC surgery · 2025Article
- Mucosal advancement flap versus ligation of the inter-sphincteric fistula tract for management of trans-sphincteric perianal fistulas in the elderly: a retrospective study.International journal of colorectal disease · 2025Observational
- Prevalence and Characteristics of Transsphincteric Anal Fistulas Unclassifiable by the Sumikoshi Classification: A Single-center Retrospective Study.Journal of the anus, rectum and colon · 2025Article
- Efficacy and safety of transanal opening of intersphincteric space in the treatment of high complex anal fistula: A meta‑analysis.Experimental and therapeutic medicine · 2024Article
- Role of Adipose Tissue Hormones in Pathogenesis of Cryptoglandular Anal Fistula.International journal of molecular sciences · 2024Article
- Slowly cutting, loose seton ligature and staged fistulotomy for healing of idiopathic perianal fistula and influence on anal continence.Langenbeck's archives of surgery · 2023Observational
- Disease Burden, Treatment Patterns, and Economic Impact of Rectovaginal Fistulas in Patients with Crohn's Disease: Findings from a Retrospective, Observational, Longitudinal Study Based on US Claims Databases.PharmacoEconomics - open · 2023Article
- OTSC Proctology clip as appropriate treatment for complicated anorectal fistula.International journal of colorectal disease · 2023Article
- Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical Outcomes.Cureus · 2023Review
- Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey.Journal of clinical medicine · 2023Article
- Clinical features and independent predictors of postoperative refractory trauma to anal fistula combined with T2DM: A propensity score-matched analysis-retrospective cohort study.Frontiers in surgery · 2023Article
- The pathogenesis of cryptoglandular anal fistula: New insight into the immunological profile.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePerianal fistulas, and specifically high perianal fistulas, remain a surgical treatment challenge. Many techniques have, and still are, being developed to improve outcome after surgery. A systematic review and meta-analysis was performed for surgical treatments for high cryptoglandular perianal fistulas.
methodsMedline (Pubmed, Ovid), Embase and The Cochrane Library databases were searched for relevant randomized controlled trials on surgical treatments for high cryptoglandular perianal fistulas. Two independent reviewers selected articles for inclusion based on title, abstract and outcomes described. The main outcome measurement was the recurrence/healing rate. Secondary outcomes were continence status, quality of life and complications.
resultsThe number of randomized trials available was low. Fourteen studies could be included in the review. A meta-analysis could only be performed for the mucosa advancement flap versus the fistula plug, and did not show a result in favour of either technique in recurrence or complication rate. The mucosa advancement flap was the most investigated technique, but did not show an advantage over any other technique. Other techniques identified in randomized studies were seton treatment, medicated seton treatment, fibrin glue, autologous stem cells, island flap anoplasty, rectal wall advancement flap, ligation of intersphincteric fistula tract, sphincter reconstruction, sphincter-preserving seton and techniques combined with antibiotics. None of these techniques seem superior to each other.
conclusionsThe best surgical treatment for high cryptoglandular perianal fistulas could not be identified. More randomized controlled trials are needed to find the best treatment. The mucosa advancement flap is the most investigated technique available.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.