Evidence map›Paper›PMID 41699414›Full record

Observational studyColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2026

Autologous skin graft intersphincteric implantation in anal fistula treatment (ASGIIFT) - A novel surgical technique in the treatment of complex transsphincteric anal fistulas.

Damir Karlović, Dorian Kršul, Dora Fučkar Čupić, Marko Zelić

Abstract readObservational Study
In one paragraph

Observational study in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Damir KarlovićDepartment of Digestive Surgery, University Hospital Rijeka, Rijeka, Croatia.ORCID https://orcid.org/0000-0001-9804-0198
Dorian KršulDepartment of Digestive Surgery, University Hospital Rijeka, Rijeka, Croatia.ORCID https://orcid.org/0000-0002-3128-4830
Dora Fučkar ČupićCenter for Digestive and Metabolic Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.ORCID https://orcid.org/0000-0001-6909-1631
Marko ZelićDepartment of Digestive Surgery, University Hospital Rijeka, Rijeka, Croatia.ORCID https://orcid.org/0000-0001-6465-3180

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThis study aimed to evaluate whether implantation of an autologous skin graft in the intersphincteric space, as part of the ASGIIFT procedure, improves the primary healing of complex transsphincteric cryptoglandular anal fistulas.

methodsA prospective observational IDEAL stage 2a study was conducted at a tertiary referral centre for minimally invasive colorectal surgery and proctology in Croatia between September 2021 and January 2023, with an 18-month follow-up. Preoperative pelvic MRI was performed in all cases, and 40 adult patients who met the inclusion criteria were included in the study. The primary outcome was the postoperative primary healing rate which was defined clinically. Secondary outcomes included postoperative continence disturbance, postoperative pain, time of healing and other postoperative complications (Wexner score and VAS - Visual Analogue Scale were used). The ASGIIFT procedure includes all standard steps of the LIFT technique (ligation of the intersphincteric fistula tract), with the addition of a pre-prepared autologous dermal graft placed into the intersphincteric space. The study was approved by the institutional ethics committee.

resultsPrimary clinical healing was achieved in 35 patients (87.5%) within a median of 4 weeks postoperatively (range 3-6 weeks). Five initially unhealed patients showed conversion from transsphincteric to intersphincteric fistula during the follow-up period and were subsequently treated by fistulotomy without complications. No patient experienced worsening continence, and no serious postoperative complications occurred.

conclusionASGIIFT appears to be a safe and feasible technique for treating transsphincteric anal fistulas, showing promising early results in this single-centre IDEAL 2a study. Further prospective comparative studies are warranted to validate these initial findings.

Indexed as

Anal CanalRectal FistulaSkin TransplantationAdultColorectal Surgical ProceduresFecal IncontinenceFemaleHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesTransplantation, AutologousTreatment OutcomeWound Healinganal fistulaautograftfaecal incontinenceimplantation

Identifiers

PMID41699414
PMCPMC12909654

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.