PMID- 26990602
OWN - NLM
STAT- MEDLINE
DCOM- 20170718
LR  - 20181202
IS  - 1463-1318 (Electronic)
IS  - 1462-8910 (Linking)
VI  - 18
IP  - 5
DP  - 2016 May
TI  - Adoption and success rates of perineal procedures for fistula-in-ano: a 
      systematic review.
PG  - 441-58
LID - 10.1111/codi.13330 [doi]
AB  - AIM: Several sphincter-preserving techniques have been described with extremely 
      encouraging initial reports. However, more recent studies have failed to confirm 
      the positive early results. We evaluate the adoption and success rates of 
      advancement flap procedures (AFP), fibrin glue sealant (FGS), anal collagen plug 
      (ACP) and ligation of intersphincteric fistula tract (LIFT) procedures based on 
      their evolution in time for the management of anal fistula. METHOD: A PubMed 
      search from 1992 to 2015. An assessment of adoption, duration of study and 
      success rate was undertaken. RESULTS: We found 133 studies (5604 patients): AFP 
      (40 studies, 2333 patients), FGS (31 studies, 871 patients), LIFT (19 studies, 
      759 patients), ACP (43 studies, 1641 patients). Success rates ranged from 0% to 
      100%. Study duration was significantly associated with success rates in AFP 
      (P = 0.01) and FGS (P = 0.02) but not in LIFT or ACP. The duration of use of 
      individual procedures since first publication was associated with success rate 
      only in AFP (P = 0.027). There were no statistically significant differences in 
      success rates relative to the number of the patients included in each study. 
      CONCLUSION: Success and adoption rates tend to decrease with time. Differences in 
      patient selection, duration of follow-up, length of availability of the 
      individual procedure and heterogeneity of treatment protocols contribute to the 
      diverse results in the literature. Differences in success rates over time were 
      evident, suggesting that both international trials and global best practice 
      consensus are desirable. Further prospective randomized controlled trials with 
      homogeneity and clear objective parameters would be needed to substantiate these 
      findings.
CI  - Colorectal Disease (c) 2016 The Association of Coloproctology of Great Britain and 
      Ireland.
FAU - Kontovounisios, C
AU  - Kontovounisios C
AD  - Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK.
AD  - Department of Colorectal Surgery, Chelsea and Westminster Hospital, London, UK.
FAU - Tekkis, P
AU  - Tekkis P
AD  - Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK.
AD  - Department of Colorectal Surgery, Chelsea and Westminster Hospital, London, UK.
FAU - Tan, E
AU  - Tan E
AD  - Department of Colorectal Surgery, Chelsea and Westminster Hospital, London, UK.
FAU - Rasheed, S
AU  - Rasheed S
AD  - Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK.
FAU - Darzi, A
AU  - Darzi A
AD  - Department of Colorectal Surgery, The Royal Marsden Hospital, London, UK.
FAU - Wexner, S D
AU  - Wexner SD
AD  - Department of Colorectal Surgery in the Digestive Disease Center, Cleveland 
      Clinic, Weston, FL, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Colorectal Dis
JT  - Colorectal disease : the official journal of the Association of Coloproctology of 
      Great Britain and Ireland
JID - 100883611
RN  - 0 (Fibrin Tissue Adhesive)
RN  - 9007-34-5 (Collagen)
SB  - IM
MH  - Anal Canal/surgery
MH  - Collagen
MH  - Digestive System Surgical Procedures/*methods
MH  - Fibrin Tissue Adhesive
MH  - Humans
MH  - Ligation/methods
MH  - Patient Selection
MH  - Perineum/*surgery
MH  - Rectal Fistula/*surgery
MH  - Surgical Flaps
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Fistula-in-ano
OT  - advancement flap procedure
OT  - anal collagen plug
OT  - fibrin glue sealant
OT  - ligation of the intersphincteric fistula tract
EDAT- 2016/03/19 06:00
MHDA- 2017/07/19 06:00
CRDT- 2016/03/19 06:00
PHST- 2015/06/28 00:00 [received]
PHST- 2016/01/04 00:00 [accepted]
PHST- 2016/03/19 06:00 [entrez]
PHST- 2016/03/19 06:00 [pubmed]
PHST- 2017/07/19 06:00 [medline]
AID - 10.1111/codi.13330 [doi]
PST - ppublish
SO  - Colorectal Dis. 2016 May;18(5):441-58. doi: 10.1111/codi.13330.