ArticleWorld journal of gastrointestinal surgery2021
Lessons learned from an audit of 1250 anal fistula patients operated at a single center: A retrospective review.
Article in World journal of gastrointestinal surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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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.
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Who cites it
24 citing papers in PubMed, 45 citations in OpenAlex.
- Prospective observation study of incision and drainage vs drainage and initial fistula management for perianal abscesses.Langenbeck's archives of surgery · 2026Trial
- 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
- Letter to Editor: "Transanal opening of intersphincteric space (TROPIS) for high complex fistulas: update from the innovator after a decade's experience".International journal of surgery (London, England) · 2026Article
- Why Transanal Opening of Intersphincteric Space (TROPIS) is effective in high complex anal fistula?Surgery open science · 2025Article
- A Pilot Study of Porcine Acellular Bladder Matrix Filling in the Treatment of Anal Fistulas: A Single-Center Cohort Study.ANZ journal of surgery · 2025Article
- Systematic review and meta-analysis of Transanal Opening of Intersphincteric Space (TROPIS) versus conventional treatments for anal fistula.Surgery open science · 2025Review
- Process to determine the level of the primary internal opening of anal fistula on magnetic resonance imaging.Annals of coloproctology · 2025Article
- High complex anal fistula managed by the modified transanal opening of the intersphincteric spaceWorld journal of radiology · 2024Article
- 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
- Cutting seton is an inferior version of fistulotomy and is associated with increased morbidity in the management of anal fistulas.Techniques in coloproctology · 2024Article
- Efficacy of cx601 (darvadstrocel) for the treatment of perianal fistulizing Crohn's disease-A prospective nationwide multicenter cohort study.Wiener klinische Wochenschrift · 2024Article
- Preoperative Assessment of Perianal Fistulas with Combined Magnetic Resonance and Tridimensional Endoanal Ultrasound: A Prospective Study.Diagnostics (Basel, Switzerland) · 2023Article
- Characteristics and post-operative outcomes of surgery for fistula-in-ano managed at a tertiary care hospital in Sri Lanka: a retrospective study.The Journal of international medical research · 2023Article
- Predictors of outcome in cryptoglandular anal fistula according to magnetic resonance imaging: A systematic review.Health science reports · 2023Article
- TROPIS (Transanal Opening of Intersphincteric Space) Procedure for the Treatment of Horseshoe Anal Fistulas.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Efficacy of Kegel exercises in preventing incontinence after partial division of internal anal sphincter during anal fistula surgery.World journal of clinical cases · 2022Article
- Comparison between recent sphincter-sparing procedures for complex anal fistulas-ligation of intersphincteric tractWorld journal of gastrointestinal surgery · 2022Review
- Guidelines to diagnose and treat peri-levator high-5 anal fistulas: Supralevator, suprasphincteric, extrasphincteric, high outersphincteric, and high intrarectal fistulas.World journal of gastroenterology · 2022Review
- Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula.World journal of gastrointestinal surgery · 2022Review
- Non-Locatable Internal Opening in Anal Fistula Associated with Acute Abscess and Its Definitive Management by Garg Protocol.Clinical and experimental gastroenterology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA complex anal fistula is a challenging disease to manage.
aimTo review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center.
methodsAnal fistulas operated on by a single surgeon over 14 years were analyzed. Preoperative magnetic resonance imaging was done in all patients. Four procedures were performed: fistulotomy; two novel sphincter-saving procedures, proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts (PERFACT) and transanal opening of intersphincteric space (TROPIS), and anal fistula plug. PERFACT was initiated before TROPIS. As per the institutional GFRI algorithm, fistulotomy was done in simple fistulas, and TROPIS was done in complex fistulas. Fistulas with associated abscesses were treated by definitive surgery. Incontinence was evaluated objectively by Vaizey incontinence scores.
resultsA total of 1351 anal fistula operations were performed in 1250 patients. The overall fistula healing rate was 19.4% in anal fistula plug (
conclusionFistulotomy had a high 98.6% healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously. The sphincter-sparing procedure, TROPIS, was safe, with a satisfactory 86% healing rate for complex fistulas. This is the largest anal fistula series to date.
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