Evidence map›Paper›PMID 30187157›Full record

ArticleInternational journal of colorectal disease2019

Mucosal advancement flap for recurrent complex anal fistula: a repeatable procedure.

Michele Podetta, Cosimo Riccardo Scarpa, Guillaume Zufferey, Karel Skala, Frederic Ris, Bruno Roche, Nicolas Christian Buchs

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Michele PodettaProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland. michelepodetta@gmail.com.ORCID http://orcid.org/0000-0003-1161-3323
Cosimo Riccardo ScarpaProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Guillaume ZuffereyProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Karel SkalaProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Frederic RisProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Bruno RocheProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
Nicolas Christian BuchsProctology Unit, Service of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.
University Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMucosal advancement flap (MAF) is the best option for complex anal fistula (AF) treatment. Recurrence is not rare and the best surgical option for his handling is a challenge considering the incontinence risk and the healing rate. We aimed to determine the feasibility and outcomes of a second MAF for recurrent complex AF previously treated with mucosal advancement flap.

methodsWe retrospectively identified 32 patients undergoing two or more MAF for recurrent AF in a larger cohort of 121 consecutive cases of MAF operated by the same senior colorectal surgeon. Only complex AF of cryptoglandular origin was enrolled. A long-term follow-up was performed collecting clinical and functional data.

resultsAmong 121 patients (group A) treated with mucosal advancement flap, 32 (26.4%) (group B) recurred with a complex AF requiring a second mucosal advancement flap procedure. Success rate of group B is 78.1%. Six patients of group B recurred a second time, another MAF was performed with healing in all cases. Complication rate (Clavien Dindo 3b) of group B is 9.4% compared to 8.3% of group A. A slight continence deficit (Miller score 1, 2, and 4) was detected after the first MAF in 3 patients. The Miller score for these patients did not change after the subsequent MAF.

conclusionsMAF is effective for treatment of complex recurrent AF. A pre-existing MAF procedure does not worsen the healing rate of the second flap. The rate of surgical complications is similar with those reported in the literature for MAFs.

Indexed as

Surgical FlapsAdultFemaleHumansMaleMiddle AgedMucous MembranePostoperative ComplicationsRecovery of FunctionRectal FistulaRecurrenceTreatment OutcomeAnal fistulaCryptoglandular fistulaFistula repairMucosal advancement flapSurgery for anal fistula

Identifiers

PMID30187157
OpenAlexW2890895659

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.