PMID- 36176822
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221001
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 8
DP  - 2022 Aug
TI  - A Comparison of Different Surgical Treatments for Complex Anal Fistula: A 
      Systematic Review.
PG  - e28289
LID - 10.7759/cureus.28289 [doi]
LID - e28289
AB  - 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.
CI  - Copyright (c) 2022, Zahra et al.
FAU - Zahra, Anam
AU  - Zahra A
AD  - Surgery, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Malla, Jyothirmai
AU  - Malla J
AD  - Surgery, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Selvaraj, Ramaneshwar
AU  - Selvaraj R
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Dhanoa, Ravneet K
AU  - Dhanoa RK
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Venugopal, Sathish
AU  - Venugopal S
AD  - Neurology, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Shoukrie, Shoukrie I
AU  - Shoukrie SI
AD  - Orthopedics and Traumatology, California Institute of Behavioral Neurosciences & 
      Psychology, Fairfield, USA.
FAU - Selvamani, Tharun Y
AU  - Selvamani TY
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Hamouda, Ranim K
AU  - Hamouda RK
AD  - Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
FAU - Hamid, Pousette
AU  - Hamid P
AD  - Neurology, California Institute of Behavioral Neurosciences & Psychology, 
      Fairfield, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220823
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9512314
OTO - NOTNLM
OT  - draining seton
OT  - endorectal advancement flap
OT  - fecal incontinence
OT  - high cryptoglandular perianal fistula
OT  - rectal fistula
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/10/01 06:00
MHDA- 2022/10/01 06:01
PMCR- 2022/08/23
CRDT- 2022/09/30 02:36
PHST- 2022/03/23 00:00 [received]
PHST- 2022/08/23 00:00 [accepted]
PHST- 2022/09/30 02:36 [entrez]
PHST- 2022/10/01 06:00 [pubmed]
PHST- 2022/10/01 06:01 [medline]
PHST- 2022/08/23 00:00 [pmc-release]
AID - 10.7759/cureus.28289 [doi]
PST - epublish
SO  - Cureus. 2022 Aug 23;14(8):e28289. doi: 10.7759/cureus.28289. eCollection 2022 
      Aug.