PMID- 33353263
OWN - NLM
STAT- MEDLINE
DCOM- 20210115
LR  - 20210115
IS  - 1671-0274 (Print)
IS  - 1671-0274 (Linking)
VI  - 23
IP  - 12
DP  - 2020 Dec 25
TI  - [Consensus of Chinese experts on the diagnosis and treatment of anal fistula 
      (2020)].
PG  - 1123-1130
LID - 10.3760/cma.j.cn.441530-20200925-00537 [doi]
AB  - Anal fistula is one of the most common diseases in colorectal and anal surgery. 
      Most of them are formed after the abscess of perianal space reptures. Due to the 
      complexity and diversity of pathological changes, the clinical efficacy of some 
      patients is not optimistic, and there may even be serious surgical complications, 
      including delayed healing of anal fistula or varying degrees of fecal 
      incontinence, which significantly affect the quality of life of patients and even 
      lead to disability. The Working Committee of Clinical Guidelines of Anorectal 
      Physicians Branch of Chinese Medical Association organized some domestic experts 
      to discuss and prepare this expert consensus. It is suggested that comprehensive 
      evaluation of anal fistula, including detailed medical history, physical 
      examination and necessary auxiliary examination should be conducted before 
      treatment. Auxiliary examinations include fistulography, ultrasound, CT or MRI. 
      The purpose of the auxiliary examination is to accurately determine the position 
      of the internal orifice of the anal fistula, the direction of the fistula and its 
      relationship with the anal sphincter. Adenogenic anal fistula needs surgical 
      treatment after diagnosis. The operation methods can be divided into two types: 
      operations breaching sphincter and operations preserving sphincter function. The 
      former includes anal fistulectomy, anal fistulotomy and seton placement; the 
      latter includes ligation of intersphincteric fistula (LIFT), rectal mucosal 
      muscle flap advancement repair, anal fistula laser closure, video-assisted anal 
      fistula treatment, etc. It is suggested to select or combine the application 
      according to the specific condition of patients. Bioabsorbable materials include 
      anal fistula plug and fibrin glue. Due to the characteristics of retaining 
      sphincter function and reusability, it is recommended to be used selectively by 
      qualified and experienced doctors. Proper wound management after anal fistula 
      surgery can reduce the pain of patients, promote healing and reduce the 
      recurrence of anal fistula. Because there is a certain risk of recurrence and 
      fecal incontinence after anal fistula surgery, for some patients with complex 
      condition, repeated operations or impaired anal function, we must be careful when 
      choosing reoperation, and weigh the benefits of patients and the risk of fecal 
      incontinence.
CN  - Clinical Guidelines Committee, Colorectal Surgeons Branch of Chinese Medical 
      Doctor Association
LA  - chi
GR  - 17JR5RA331/National Science Foundation of Gansu Province/
GR  - GSWSKY2018-03/Research Plan of Health Industry in Gansu Province/
PT  - Journal Article
PT  - Practice Guideline
PL  - China
TA  - Zhonghua Wei Chang Wai Ke Za Zhi
JT  - Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
JID - 101177990
SB  - IM
MH  - Anal Canal/diagnostic imaging/surgery
MH  - China
MH  - Consensus
MH  - *Fecal Incontinence/etiology/prevention & control
MH  - Humans
MH  - Quality of Life
MH  - *Rectal Fistula/complications/diagnosis/surgery
MH  - Reoperation/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anal fistula
OT  - Classification
OT  - Consensus
OT  - Diagnosis
OT  - Surgery
EDAT- 2020/12/24 06:00
MHDA- 2021/01/16 06:00
CRDT- 2020/12/23 03:02
PHST- 2020/12/23 03:02 [entrez]
PHST- 2020/12/24 06:00 [pubmed]
PHST- 2021/01/16 06:00 [medline]
AID - 10.3760/cma.j.cn.441530-20200925-00537 [doi]
PST - ppublish
SO  - Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Dec 25;23(12):1123-1130. doi: 
      10.3760/cma.j.cn.441530-20200925-00537.