SynthesisLangenbeck's archives of surgery2017
German S3 guidelines: anal abscess and fistula (second revised version).
Synthesis in Langenbeck's archives of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Efficacy and safety of FiLaC™ for perianal fistulizing Crohn's disease: a systematic review and meta-analysis.Techniques in coloproctology · 2022Pooled it
- Evaluation and management of perianal abscess and anal fistula: SICCR position statement.Techniques in coloproctology · 2020Guideline
- Postoperative Packing of Perianal Abscess Cavities (PPAC2): randomized clinical trial.The British journal of surgery · 2022Trial
- Three-cavity clearance significantly reduces the postoperative fistula rate and abscess recurrence following glandular perianal abscess: a single-center real-world study.Techniques in coloproctology · 2026Article
- Microbiological Profile and Antibiotic Resistance in Relation to Risk of Recurrence and Fistula Following Perianal Abscess Drainage:Saudi medical journal · 2026Article
- A DWI histogram-based nomogram for preoperative prediction of pathogens and antibiotic resistance in perianal abscesses.International journal of colorectal disease · 2026Article
- Targeting obesity and lipid metabolism profiles to prevent perianal abscesses: A case-control study and Mendelian randomization analysis.World journal of gastrointestinal surgery · 2026Article
- MRI-based radiomics-deep learning model for preoperative pathogen prediction in perianal abscesses.Frontiers in medicine · 2026Article
- Anal fistulas: do classification systems predict surgical outcomes?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- Antibiotic use during the first episode of acute perianal sepsis: a still-open question.Annals of coloproctology · 2025Article
- A randomized controlled trial of trans-intersphincteric double seton (TRISDS) for the treatment of perianal abscess.Gastroenterology report · 2025Article
- Risk factors for delayed wound healing after anal fistula surgery: Protocol of a meta-analytic study.PloS one · 2025Article
- Diagnosis and treatment for anal fistula: a systematic review of clinical practice guidelines and consensus statements.Frontiers in surgery · 2025Article
- Is Primary Opening of Fistula-in-Ano Always at Dentate Line: Correlation Between MRI and Operative Findings in 379 Patients.Clinical and experimental gastroenterology · 2025Article
- Long-term outcomes of fistula-tract laser closure for complex perianal fistulizing Crohn's disease.Techniques in coloproctology · 2024Article
- Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI.Cureus · 2024Article
- Rectovaginal Fistulas Not Involving the Rectovaginal Septum Should Be Treated Like Anal Fistulas: A New Concept and Proposal for a Reclassification of Rectovaginal Fistulas.Clinical and experimental gastroenterology · 2024Article
- Distalization of perianal fistulas after loose silicone seton drainage is a myth.Techniques in coloproctology · 2023Article
- Fistula development after anal abscess drainage-a multicentre retrospective cohort study.International journal of colorectal disease · 2023Article
- The Impact of Computed Tomography Scans on the Management and Wait Times in Perianal Abscess Diagnoses.Cureus · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of anal abscess and fistula is relatively high, and the condition is most common in young men.
methodsThis is a revised version of the German S3 guidelines first published in 2011. It is based on a systematic review of pertinent literature.
resultsCryptoglandular abscesses and fistulas usually originate in the proctodeal glands of the intersphincteric space. Classification depends on their relation to the anal sphincter. Patient history and clinical examination are diagnostically sufficient in order to establish the indication for surgery. Further examinations (endosonography, MRI) should be considered in complex abscesses or fistulas. The goal of surgery for an abscess is thorough drainage of the focus of infection while preserving the sphincter muscles. The risk of abscess recurrence or secondary fistula formation is low overall. However, they may result from insufficient drainage. Primary fistulotomy should only be performed in case of superficial fistulas. Moreover, it should be done by experienced surgeons. In case of unclear findings or high fistulas, repair should take place in a second procedure. Anal fistulas can be treated only by surgical intervention with one of the following operations: laying open, seton drainage, plastic surgical reconstruction with suturing of the sphincter (flap, sphincter repair, LIFT), and occlusion with biomaterials. Only superficial fistulas should be laid open. The risk of postoperative incontinence is directly related to the thickness of the sphincter muscle that is divided. All high anal fistulas should be treated with a sphincter-saving procedure. The various plastic surgical reconstructive procedures all yield roughly the same results. Occlusion with biomaterial results in lower cure rate.
conclusionIn this revision of the German S3 guidelines, instructions for diagnosis and treatment of anal abscess and fistula are described based on a review of current literature.
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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.