ArticleTechniques in coloproctology2019
Contemporary surgical practice in the management of anal fistula: results from an international survey.
Article in Techniques in coloproctology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- 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
- Simple fistula-in-ano: is it all simple? A systematic review.Techniques in coloproctology · 2021Pooled it
- Advancement flaps in perianal fistulizing Crohn's disease: technical steps and current evidence.Techniques in coloproctology · 2026Review
- Core-Out Fistulectomy Combined With Laser Ablation of the Trans-Sphincteric Fistula Tract: A Pilot Study of Efficacy and Safety.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Cryptoglandular Anal Fistula Core Outcome Measurement Set (AFCOMS): standardised definitions and measurement instruments.EClinicalMedicine · 2026Article
- Impact of Perianal Inflammatory Lesions in Crohn's Disease Patients with Anorectal Cancer.Journal of the anus, rectum and colon · 2026Article
- Ligation of the intersphincteric fistula fract (LIFT) in complex anorectal fistulas: retrospective analysis of the outcomes in a tertiary hospital.Updates in surgery · 2025Article
- Article
- Understanding the anatomical basis of anorectal fistulas and their surgical management: exploring different types for enhanced precision and safety.Surgery today · 2025Review
- Fistulectomy and primary sphincter reconstruction for high cryptoglandular anal fistula: a retrospective cohort study with long-term results.Surgical endoscopy · 2025Article
- A new protocolized treatment strategy optimizing medical and surgical care leads to improved healing of Crohn's perianal fistulas.Journal of Crohn's & colitis · 2025Article
- A modified sphincter-preserved procedure for high complex anal fistulas: a preliminary study.Gastroenterology report · 2025Article
- High complex anal fistula managed by the modified transanal opening of the intersphincteric spaceWorld journal of radiology · 2024Article
- Clinical and Radiological Features of Perianal Fistula: An MRI-Based Study in Addis Ababa, Ethiopia.Ethiopian journal of health sciences · 2024Article
- Immediate sphincter repair following fistulotomy for anal fistula: does it impact the healing rate and septic complications?Annals of coloproctology · 2024Article
- Distalization of perianal fistulas after loose silicone seton drainage is a myth.Techniques in coloproctology · 2023Article
- Article
- 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
- The development of a minimum dataset for MRI reporting of anorectal fistula: a multi-disciplinary, expert consensus process.European radiology · 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
9 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement of anal fistula (AF) remains challenging with many controversies. The purpose of this study was to explore current surgical practice in the management of AF with a focus on technical variations among surgeons.
methodsAn online survey was conducted by inviting all surgeons and physicians on the membership directory of European Society of Coloproctology and American Society of Colon and Rectal Surgeons. An invitation was extended to others via social media. The survey had 74 questions exploring diagnostic and surgical techniques.
resultsIn March 2018, 3572 physicians on membership directory were invited to take part in the study 510 of whom (14%) responded to the survey. Of these respondents, 492 (96%) were surgeons. Respondents were mostly colorectal surgeons (84%) at consultant level (84%), age ≥ 40 years (64%), practicing in academic (53%) or teaching (30%) hospitals, from the USA (36%) and Europe (34%). About 80% considered fistulotomy as the gold standard treatment for simple fistulas. Endorectal advancement flap was performed using partial- (42%) or full-thickness (44%) flaps. Up to 38% of surgeons performed ligation of the intersphincteric fistula tract (LIFT) sometimes with technical variations. Geographic and demographic differences were found in both the diagnostic and therapeutic approaches to AF. Declared rates of recurrence and fecal incontinence with these techniques were variable and did not correlate with surgeons' experience. Only 1-4% of surgeons were confident in performing the most novel sphincter-preserving techniques in patients with Crohn's disease.
conclusionsProfound technical variations exist in surgical management of AF, making it difficult to reproduce and compare treatment outcomes among different centers.
Indexed as
Identifiers
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.