ReviewTechniques in coloproctology2023
Efficacy of different surgical treatments for management of anal fistula: a network meta-analysis.
Review in Techniques in coloproctology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Systematic review and network meta-analysis of cryptoglandular complex anal fistula treatment: evaluation of surgical strategies.Updates in surgery · 2025Pooled it
- Efficacy of micronized purified flavonoid fraction in reducing pain after anal fistula surgery: a randomized controlled trial.Techniques in coloproctology · 2026Trial
- Comparison of incision and drainage procedure with drainage and ligation of the intersphincteric fistula tract in the treatment of deep perianal abscess.Scientific reports · 2026Article
- Long-term outcomes of video-assisted anal fistula treatment.Surgical endoscopy · 2026Observational
- Ascending complex anal fistula secondary to lower extremity soft tissue infection: a case report.Frontiers in surgery · 2026Article
- Ligation of the intersphincteric fistula tract vs. fistulotomy for complex anal fistula: a retrospective study.American journal of translational research · 2026Article
- Article
- Enhanced surgical management of complex anal fistulasWorld journal of gastrointestinal surgery · 2025Article
- Female Trans-Sphincteric Anterior Anal Fistula: Still an Unsolved Problem-Results from a Nationwide Cohort Study.Journal of clinical medicine · 2025Article
- Ligation of the intersphincteric fistula fract (LIFT) in complex anorectal fistulas: retrospective analysis of the outcomes in a tertiary hospital.Updates in surgery · 2025Article
- Modified fistulotomy with internal orifice distalization for optimized perianal fistula management: Pressure zone transition.World journal of gastrointestinal surgery · 2025Article
- Mid- and long-term functional outcomes of advancement flap for cryptoglandular perianal fistulas.Techniques in coloproctology · 2025Article
- Understanding the anatomical basis of anorectal fistulas and their surgical management: exploring different types for enhanced precision and safety.Surgery today · 2025Review
- Fistulectomy and primary sphincter reconstruction for high cryptoglandular anal fistula: a retrospective cohort study with long-term results.Surgical endoscopy · 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
- Different tightening schemes in thread-drawing therapy and their effects on anal function recovery in patients with high simple anal fistula.Frontiers in physiology · 2025Article
- Needs Analysis of Supportive Care for Postoperative Wound Rehabilitation in Anal Fistula Patients Based on the Kano Model.Journal of multidisciplinary healthcare · 2025Article
- Efficacy of anal duct ligation and muscle closure: A novel sphincter-preserving surgical technique for fistula-in-ano.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- Learning curve and safety of the implementation of laparoscopic complete mesocolic excision with intracorporeal anastomosis for right-sided colon cancer: results from a propensity score-matched study.Surgical endoscopy · 2024Article
- LIFT procedure: future direction for research.Updates in surgery · 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
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCurrently, the anal fistula treatment which optimises healing and preserves bowel continence remains unclear. The aim of our study was to compare the relative efficacy of different surgical treatments for AF through a network meta-analysis.
methodsSystematic searches of MEDLINE, EMBASE and CENTRAL databases up to October 2022 identified randomised controlled trials (RCTs) comparing surgical treatments for anal fistulae. Fistulae were classified as simple (inter-sphincteric or low trans-sphincteric fistulae crossing less than 30% of the external anal sphincter (EAS)) and complex (high trans-sphincteric fistulae involving more than 30% of the EAS). Treatments evaluated in only one trial were excluded from the primary analyses to minimise bias. The primary outcomes were rates of success in achieving AF healing and bowel incontinence.
resultsFifty-two RCTs were included. Of the 14 treatments considered, there were no significant differences regarding short-term (6 months or less postoperatively) and long-term (more than 6 months postoperatively) success rates between any of the treatments in patients with both simple and complex anal fistula. Ligation of the inter-sphincteric fistula tract (LIFT) ranked best for minimising bowel incontinence in simple (99.1% of comparisons; 3 trials, n = 70 patients) and complex anal fistula (86.2% of comparisons; 3 trials, n = 102 patients).
conclusionsThere is insufficient evidence in existing RCTs to recommend one treatment over another regarding their short and long-term efficacy in successfully facilitating healing of both simple and complex anal fistulae. However, LIFT appears to be associated with the least impairment of bowel continence, irrespective of AF classification.
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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.