ReviewInternational journal of colorectal disease2021
Surgery for anal fistulae: state of the art.
Review in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Failure rates and complications of four sphincter-sparing techniques for the treatment of fistula-in-ano: a systematic review and network meta-analysis.Techniques in coloproctology · 2025Pooled it
- Ischiorectal abscess with fistulization into the thigh, the 'perfect storm' patient.Journal of surgical case reports · 2026Article
- Clinical efficacy and failure-related factors of the loose-seton procedure combined with transanal opening of the intersphincteric space technique (LoSet-TROPlS) in the treatment of complex anal fistulas.Techniques in coloproctology · 2026Article
- Imaging of perineal suppurations: a pictorial essay.Abdominal radiology (New York) · 2026Review
- Evidence outside the box: Minimally invasive treatment for anal fistula.World journal of gastrointestinal surgery · 2025Review
- Female Trans-Sphincteric Anterior Anal Fistula: Still an Unsolved Problem-Results from a Nationwide Cohort Study.Journal of clinical medicine · 2025Article
- Article
- Understanding the anatomical basis of anorectal fistulas and their surgical management: exploring different types for enhanced precision and safety.Surgery today · 2025Review
- Mucosal advancement flap versus ligation of the inter-sphincteric fistula tract for management of trans-sphincteric perianal fistulas in the elderly: a retrospective study.International journal of colorectal disease · 2025Observational
- Article
- Article
- Garg scoring system to predict long-term healing in cryptoglandular anal fistulas: a prospective validation study.Annals of coloproctology · 2024Article
- Use of Non-Thermal Plasma as Postoperative Therapy in Anal Fistula: Clinical Experience and Results.Biomedicines · 2024Article
- Article
- Surgical treatment trends and outcomes for anal fistula: fistulotomy is still accurate and safe. Results from a nationwide observational study.Techniques in coloproctology · 2023Observational
- Collagen treatment of complex anorectal fistula: 3 years follow-up.Open medicine (Warsaw, Poland) · 2023Article
- Clinical features and independent predictors of postoperative refractory trauma to anal fistula combined with T2DM: A propensity score-matched analysis-retrospective cohort study.Frontiers in surgery · 2023Article
- Efficacy of Kegel exercises in preventing incontinence after partial division of internal anal sphincter during anal fistula surgery.World journal of clinical cases · 2022Article
- The relationship between anal disease and quality of life: a bibliometric study.Annals of translational medicine · 2022Article
- A Novel MRI and Clinical-Based Scoring System to Assess Post-Surgery Healing and to Predict Long-Term Healing in Cryptoglandular Anal Fistulas.Clinical and experimental gastroenterology · 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
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimAnal fistulae (AF) are considered a challenge for colorectal surgeons, as they recur if not properly operated. Being a septic disease, they are correlated with immunodeficiency and surgery may be followed by anal incontinence (AI). The aim of this paper is to suggest a state-of-the-art treatment of AF.
methodsPathogenesis, classification, diagnostic tools, intraoperative assessment, and surgeries proposed for AF have been reviewed, together with the results following conventional surgery and innovations aimed at sphincters' preservation.
resultsStress causes immunodepression and favors anal sepsis, and heavy smoking facilitates AF recurrences. Evacuation fistulography, MRI, and transanal ultrasound may help the diagnosis. Fistulotomy allows high cure rate, up to 96.4%, but may cause up to 64% of AI in transsphincteric AF. Fistulectomy with rectal advancement flap is effective in 80% of these cases and avoids AI. Other options are either suturing of AF internal orifice or positioning a cutting seton. Ligation of intersphincteric fistula track (LIFT) is a costless alternative carrying a success of 57-99% with 0-23% AI. Costly innovations, i.e., autologous stem cells, porcine derma sheet (Permacol), video-assisted fistula excision (VAAFT), porcine matrix (PLUG), and laser closure (FiLaC), minimize AI, but may carry AF recurrence. Their grades of recommendation range between 2B and 2C in the Guidelines of the Italian Society of Colorectal Surgery.
conclusionPostoperative incontinence in transsphincteric AF may be minimized by both costless and costly sphincter-saving procedures, the latter carrying higher recurrence rate. The success of surgery may be increased by a different lifestyle.
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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.