SynthesisTechniques in coloproctology2025
Failure rates and complications of four sphincter-sparing techniques for the treatment of fistula-in-ano: a systematic review and network meta-analysis.
Synthesis in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Comparative analysis of early and late recurrence rates in perianal fistula surgery.Experimental and therapeutic medicine · 2026Article
- Essential Updates in the Surgical Management of Inflammatory Bowel Disease: Current Topics From 2024 to Mid-2026.Annals of gastroenterological surgery · 2026Review
- Autologous platelet-rich fibrin matrix (Obsidian RFT) as a sphincter-preserving treatment for anal fistula: a retrospective cohort study and subgroup analysis.Surgical endoscopy · 2026Article
- Platelet-rich fibrin matrix as treatment for complex anal fistulae: A 3-year experience at a tertiary centre.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Core-Out Fistulectomy Combined With Laser Ablation of the Trans-Sphincteric Fistula Tract: A Pilot Study of Efficacy and Safety.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Fistulotomy and lateral internal sphincterotomy: two sides of the same coin in the treatment of simple anal fistulas and anal fissures.Techniques in coloproctology · 2026Article
- Ligation of the intersphincteric fistula tractWorld journal of gastrointestinal surgery · 2026Article
- Complete Healing After Umbilical Mesenchymal Stem Cell-Derived Exosome Therapy For a Refractory Complex Anal Fistula.Cureus · 2026Article
- Invited comment on Pescatori: Prevention of postoperative fecal incontinence after anal fistula surgery.Techniques in coloproctology · 2026Article
- A randomized controlled study on the efficacy and function of internal sphincter lowering combined with external sphincter denudation and virtual hanging drainage in the treatment of complex anal fistula.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
- Endoscopic Identification of a Hidden Internal Opening Using Video-Assisted Anal Fistula Treatment (VAAFT).Cureus · 2025Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral techniques are available to reduce the risk of sphincter injury when treating anal fistula, such as ligation of the intersphincteric fistula tract (LIFT), video-assisted anal fistula treatment (VAAFT), fistula laser closure (FiLaC) and endoanal flap (EAF). The aim of this meta-analysis is to provide data on the safety, complications and failure of these techniques.
methodsStudies published after 2017, with patients undergoing at least one among LIFT, VAAFT, FiLaC and EAF for perianal fistula and providing data regarding failure, were retrieved from PubMed and EMBASE. Primary outcome was failure; other outcomes included continence disturbance and complications.
resultsForty-nine articles with 3520 patients were included. The failure rates were 28.6% (range 3.8-75) for LIFT, 22.3% (6.2-65.2) for VAAFT, 43.9% (11.1-80) for FiLaC and 25.9% (4.7-100) for EAF, with a mean follow-up of 35.4 (6-80.4), 32.4 (6-48), 31.6(6.3-60) and 42.4 (12-155) months. The available network meta-analysis on failure showed RD of -0.08 (95% CI - 0.58 to 0.42) comparing LIFT vs VAAFT and 0.30 (95% CI 0.03 to 0.58) comparing LIFT vs EAF. No patients undergoing VAAFT or FiLaC reported worsening continence, while for LIFT and EAF, the continence disturbance rate was 1.5% and 7.3%, respectively. No major complications were observed. The most common minor complications were pain (1.4%), bleeding (1.1%) and wound infection (1.2%). Overall, minor complication rates were 4.3% for LIFT, 7.2% for VAAFT, 10.2% for FiLaC and 6.2% for EAF. Crohn's disease was associated with a higher failure rate (39.5% vs 31.4%).
conclusionsFiLaC, VAAFT, LIFT and EAF may represent a valid option in the treatment of anal fistula. VAAFT showed the lowest rate of failure but with no differences from network metanalysis. Wider homogeneous studies with long-term follow-up are necessary to obtain more robust data. PROSPERO NUMBER: CRD42022375600.
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