Evidence map›Paper›PMID 36217811›Full record

ArticleAnnals of coloproctology2024

Garg scoring system to predict long-term healing in cryptoglandular anal fistulas: a prospective validation study.

Sushil Dawka, Vipul D Yagnik, Baljit Kaur, Geetha R Menon, Pankaj Garg

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Article in Annals of coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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5 citing papers in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Sushil DawkaDepartment of Surgery, SSR Medical College, Belle Rive, Mauritius.
Vipul D YagnikDepartment of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Center, Patan, India.
Baljit KaurDepartment of Radiology, SSRD Magnetic Resonance Imaging Institute, Chandigarh, India.
Geetha R MenonDepartment of National Statistics, Indian Council of Medical Research, New Delhi, India.
Pankaj GargDepartment of Colorectal Surgery, Indus Super Specialty Hospital, Mohali, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeComplex anal fistulas can recur after clinical healing, even after a long interval which leads to significant anxiety. Also, ascertaining the efficacy of any new treatment procedure becomes difficult and takes several years. We prospectively analyzed the validity of Garg scoring system (GSS) to predict long-term fistula healing.

methodsIn patients operated for cryptoglandular anal fistulas, magnetic resonance imaging was performed preoperatively and at 3 months postoperatively to assess fistula healing. Scores as per the GSS were calculated for each patient at 3 months postoperatively and correlated with long-term healing to check the accuracy of the scoring system.

resultsFifty-seven patients were enrolled, but 50 were finally included (7 were excluded). These 50 patients (age, 41.2±12.4 years; 46 men) were followed up for 12 to 20 months (median, 17 months). Forty-seven patients (94.0%) had complex fistulas, 28 (56.0%) had recurrent fistulas, 48 (96.0%) had multiple tracts, 20 (40.0%) had horseshoe tracts, 15 (32.0%) had associated abscesses, 5 (10.0%) were suprasphincteric, and 8 (16.0%) were supralevator fistulas. The GSS could accurately predict long-term healing (high positive predictive value, 31 of 31 [100%]) but was not very accurate in predicting nonhealing (negative predictive value, 15 of 19 [78.9%]). The sensitivity in predicting healing was 31 of 35 (88.6%).

conclusionGSS accurately predicts long-term fistula with a high positive predictive value (100%) but is less accurate in predicting nonhealing. This scoring system can help allay anxiety in patients and facilitate the early validation of innovative procedures for anal fistulas.

Indexed as

Fecal incontinenceMagnetic resonance imagingRectal fistulaRecurrence

Identifiers

PMID36217811
PMCPMC11532377

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