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A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review

Fistula-in-ano is a common proctological condition that primarily affects younger people and leads to chronic morbidity. An anal fistula is divided into simple and complex fistulas. A complex fistula is a challenging problem due to higher recurrence rates and incontinence associated with surgery. Ma...

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Autores principales: Zahra, Anam, Malla, Jyothirmai, Selvaraj, Ramaneshwar, Dhanoa, Ravneet K, Venugopal, Sathish, Shoukrie, Shoukrie I, Selvamani, Tharun Y, Hamouda, Ranim K, Hamid, Pousette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512314/
https://www.ncbi.nlm.nih.gov/pubmed/36176822
http://dx.doi.org/10.7759/cureus.28289
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author Zahra, Anam
Malla, Jyothirmai
Selvaraj, Ramaneshwar
Dhanoa, Ravneet K
Venugopal, Sathish
Shoukrie, Shoukrie I
Selvamani, Tharun Y
Hamouda, Ranim K
Hamid, Pousette
author_facet Zahra, Anam
Malla, Jyothirmai
Selvaraj, Ramaneshwar
Dhanoa, Ravneet K
Venugopal, Sathish
Shoukrie, Shoukrie I
Selvamani, Tharun Y
Hamouda, Ranim K
Hamid, Pousette
author_sort Zahra, Anam
collection PubMed
description Fistula-in-ano is a common proctological condition that primarily affects younger people and leads to chronic morbidity. An anal fistula is divided into simple and complex fistulas. A complex fistula is a challenging problem due to higher recurrence rates and incontinence associated with surgery. Many new methods have been developed for the closure of complex fistula-in-ano, but there is no single best method. The aim of this study is to identify a superior surgical technique for treating complex/high cryptoglandular perianal fistulas (HCPFs). A literature search was done using PubMed and Google Scholar for the period of 2012-2021. Articles that contain surgical treatment for complex anal fistula in the English language published in the last 10 years were included. The types of studies included were randomized controlled trials (RCTs), meta-analyses, systematic reviews, cohort studies, and traditional reviews. Articles excluded were those done more than 10 years ago, in other languages, and containing simple fistula management only. Nine studies were included in the review; a systematic review and meta-analysis concluded that no single method is effective. The ligation of the intersphincteric fistula tract (LIFT) procedure seems to be a promising and effective technique as it has a low rate of fecal incontinence as compared to other methods. Biological techniques give variable success rates so does fistula plug (FP). Mucosal advancement flap (MAF) and rerouting seton give good results according to one study. Fistula plug gives variable results and is not a preferred method. Ligation of the intersphincteric fistula tract (LIFT) seems to be a promising new technique for complex anal fistulas, but the data available is not enough to determine the best method. More randomized trials are required to compare traditional techniques and emerging new biological methods to see the best technique available.
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spelling pubmed-95123142022-09-28 A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review Zahra, Anam Malla, Jyothirmai Selvaraj, Ramaneshwar Dhanoa, Ravneet K Venugopal, Sathish Shoukrie, Shoukrie I Selvamani, Tharun Y Hamouda, Ranim K Hamid, Pousette Cureus General Surgery Fistula-in-ano is a common proctological condition that primarily affects younger people and leads to chronic morbidity. An anal fistula is divided into simple and complex fistulas. A complex fistula is a challenging problem due to higher recurrence rates and incontinence associated with surgery. Many new methods have been developed for the closure of complex fistula-in-ano, but there is no single best method. The aim of this study is to identify a superior surgical technique for treating complex/high cryptoglandular perianal fistulas (HCPFs). A literature search was done using PubMed and Google Scholar for the period of 2012-2021. Articles that contain surgical treatment for complex anal fistula in the English language published in the last 10 years were included. The types of studies included were randomized controlled trials (RCTs), meta-analyses, systematic reviews, cohort studies, and traditional reviews. Articles excluded were those done more than 10 years ago, in other languages, and containing simple fistula management only. Nine studies were included in the review; a systematic review and meta-analysis concluded that no single method is effective. The ligation of the intersphincteric fistula tract (LIFT) procedure seems to be a promising and effective technique as it has a low rate of fecal incontinence as compared to other methods. Biological techniques give variable success rates so does fistula plug (FP). Mucosal advancement flap (MAF) and rerouting seton give good results according to one study. Fistula plug gives variable results and is not a preferred method. Ligation of the intersphincteric fistula tract (LIFT) seems to be a promising new technique for complex anal fistulas, but the data available is not enough to determine the best method. More randomized trials are required to compare traditional techniques and emerging new biological methods to see the best technique available. Cureus 2022-08-23 /pmc/articles/PMC9512314/ /pubmed/36176822 http://dx.doi.org/10.7759/cureus.28289 Text en Copyright © 2022, Zahra et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Zahra, Anam
Malla, Jyothirmai
Selvaraj, Ramaneshwar
Dhanoa, Ravneet K
Venugopal, Sathish
Shoukrie, Shoukrie I
Selvamani, Tharun Y
Hamouda, Ranim K
Hamid, Pousette
A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title_full A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title_fullStr A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title_full_unstemmed A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title_short A Comparison of Different Surgical Treatments for Complex Anal Fistula: A Systematic Review
title_sort comparison of different surgical treatments for complex anal fistula: a systematic review
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512314/
https://www.ncbi.nlm.nih.gov/pubmed/36176822
http://dx.doi.org/10.7759/cureus.28289
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