ArticleAnnals of medicine and surgery (2012)2020
Assessing validity of existing fistula-in-ano classifications in a cohort of 848 operated and MRI-assessed anal fistula patients - Cohort study.
Article in Annals of medicine and surgery (2012), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Comparison of the proposed new classification of anal fistulas with the Garg classification.Annals of coloproctology · 2026Article
- A randomized controlled study on the efficacy and function of internal sphincter lowering combined with external sphincter denudation and virtual hanging drainage in the treatment of complex anal fistula.Frontiers in surgery · 2026Article
- Risk factors for postoperative adverse outcomes in patients with high anal fistula undergoing modified TROPIS procedure combined with Parks' fistulotomy with seton: a retrospective study.Frontiers in medicine · 2026Article
- Anal fistulas: do classification systems predict surgical outcomes?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- External validation of the modified Parks classification of cryptoglandular anal fistula to predict failure of healing: the protocol for a retrospective analysis.International journal of surgery protocols · 2025Article
- Validation of a novel imaging-guided and anatomy-based classification system for anorectal fistulas: a retrospective clinical evaluation study.Annals of coloproctology · 2025Article
- Process to determine the level of the primary internal opening of anal fistula on magnetic resonance imaging.Annals of coloproctology · 2025Article
- Ligation of the intersphincteric fistula tract (LIFT) for high transsphincteric fistulas: a double-center retrospective study with long-term follow-up.Annals of coloproctology · 2025Article
- 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
- 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
- Surgeon oriented reporting template for magnetic resonance imaging and endoanal ultrasound of anal fistulas enhances surgical decision-making.World journal of radiology · 2024Article
- Structured magnetic resonance imaging and endoanal ultrasound anal fistulas reporting template (SMART): An interdisciplinary Delphi consensus.World journal of gastrointestinal surgery · 2024Article
- Recent advances in the diagnosis and treatment of complex anal fistula.Annals of coloproctology · 2024Review
- Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study.Life (Basel, Switzerland) · 2023Article
- Newer procedures need to demonstrate efficacy in high complex anal fistulas.Annals of coloproctology · 2023Article
- Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical Outcomes.Cureus · 2023Review
- Increased Risk of Bleeding with Topical Metronidazole in a Postoperative Wound after Anal Fistula and Hemorrhoid Surgery: A Propensity Score-Matched Case-Control Study.Clinics and practice · 2022Article
- Diagnosis of anorectal tuberculosis by polymerase chain reaction, GeneXpert and histopathology in 1336 samples in 776 anal fistula patients.World journal of gastrointestinal surgery · 2021Article
- Management of Complex Cryptoglandular Anal Fistula: Challenges and Solutions.Clinical and experimental gastroenterology · 2020Review
- Using MRI to guide surgical strategy for perianal fistulas: from conventional acquisition to 3D modeling.Radiologia brasileiraReview
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Authors and funding
1 author.
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Abstract
AIM/
backgroundThe commonly used fistula-in-ano classifications, Park or St. James's University hospital(SJUH), neither grade fistulas as per their severity nor guide regarding their management. A new classification(NC), published in 2017, proposed to classify fistulas as per their severity and also guided in its management. The early grades (NC grade I & II) were simple fistulas and were amenable to fistulotomy whereas higher grades (NC grade III-V) were complex fistulas and were not amenable to fistulotomy.
methodsLower grades of all the three classifications were classified as simple (Parks: I, SJUH:I-II, NC:I-II) whereas higher grades were classified as complex (Parks: II-IV, SJUH: III-V, NC: III-V) fistulas. Fistulotomy should be possible in simple fistulas but not in complex fistulas. This was analysed for all these classifications. The long-term follow-up of continence was done by an objective scoring system (Vaizey's scores).
resultsThe SJUH & Parks classifications categorized 504/828 fistulas as 'complex' which was quite inaccurate as 42.7%(215/504) of these fistulas were safely amenable to fistulotomy. On the other hand, the New classification (NC) classified 282/828 fistulas as 'complex' which was very accurate as 99% (279/282) of these were actually complex and were not amenable to fistulotomy. The change in the preoperative and the postoperative continence scores in the patients who underwent fistulotomy, as per these classifications, Parks & SJUH vs NC, was 0.064 ± 0.62 and 0.089 ± 0.85 respectively and was not significantly different(p = 0.80, Mann-Whitney
conclusionsThe New classification(NC) seems better than the existing classifications for grading the disease as well as in guiding the management of the disease.
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