Trial reportBJS open2021
Video-assisted anal fistula treatment versus fistulectomy and sphincter repair in the treatment of high cryptoglandular anal fistula: a randomized clinical study.
Trial report in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02585167 (Endoscopic or Surgical Treatment of Complex Perianal Fistula. A Randomized Controlled Clinical Study), which is not on this map. Cited by 7 papers, 3 of them syntheses that pooled it.
What it found
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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.
Endoscopic or Surgical Treatment of Complex Perianal Fistula. A Randomized Controlled Clinical Study
Who cites it
7 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Systematic review and network meta-analysis of cryptoglandular complex anal fistula treatment: evaluation of surgical strategies.Updates in surgery · 2025Pooled it
- 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
- Pooled it
- Ligation of the intersphincteric fistula tractWorld journal of gastrointestinal surgery · 2026Article
- Evidence outside the box: Minimally invasive treatment for anal fistula.World journal of gastrointestinal surgery · 2025Review
- Fistulectomy and primary sphincter reconstruction for high cryptoglandular anal fistula: a retrospective cohort study with long-term results.Surgical endoscopy · 2025Article
- Optimum management for complex anal fistula: A network meta-analysis of randomized controlled trials.Surgery open science · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVideo-assisted anal fistula treatment (VAAFT) may have a recurrence rate comparable to that of fistulectomy and sphincter repair (FSR) in the treatment of high anal fistula and with potential advantages in wound healing, functional outcome and quality of life. The aim and objectives of the study are to compare the outcome of VAAFT with that of FSR for high cryptoglandular anal fistula.
methodsThis was a single-centre randomized controlled trial of adults with high anal fistula comparing FSR with VAAFT. Primary outcome was fistula recurrence. Secondary outcomes were results of anal manometry, quality of life and faecal continence. A power calculation of 33 patients in each arm (1 : 1) was based on recurrence in the FSR and VAAFT groups of 5 per cent and 30 per cent respectively. Follow-up at 6 months after surgery included physical examination, MRI, anal manometry, quality-of-life assessment (RAND SF 36 questionnaire) and faecal-continence assessment (Wexner score).
resultsThe study was terminated early due to high recurrence rates in both groups. A total of 45 patients were included. Recurrence rates were 65 per cent for VAAFT and 27 per cent for FSR, with hazard ratio 4.18 (P = 0.016). Length of the fistula was a risk factor with an association with recurrence (hazard ratio 1.8, P = 0.020). There were significant differences in quality of life in favour of FSR and in anal manometry in favour of VAAFT with a significant improvement in Wexner score in both groups.
conclusionFSR was associated with a lower recurrence rate than VAAFT in the management of complex anal fistulae in this single-centre study but the study was terminated early due to higher than predicted recurrence rate in both groups. REGISTRATION NUMBER: NCT02585167 (http://www.clinicaltrials.org).
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