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1Department of Surgery, King’s College Hospital Dubai, Dubai, United Arab Emirates
2Department of Surgery, Kaiser Permanente, Los Angeles, CA, USA
3Department of Surgery, Northwestern University, Chicago, IL, USA
© 2024 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
No potential conflict of interest relevant to this article was reported.
Funding
None.
Author contributions
Conceptualization: all authors; Formal analysis: ATT, MA; Investigation: ATT, MA; Methodology: all authors; Resources: ATT, MA; Writing–original draft: MAA; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Study | Study type | No. of patients | Mean follow-up (mo) | Healing rate (%) | Sphincter repair dehiscence (%) | Septic complication (%) | Postoperative continence disturbance (%) |
---|---|---|---|---|---|---|---|
Parkash et al. [24] (1985)] | Retrospective | 120 | 6–60a | 96.6 | 11.7 | - | 0 |
Christiansen and Rønholt [25] (1995) | Prospective | 14 | 12–48a | 85.7 | - | - | 21.4 |
Gemsenjäger [26] (1996) | Retrospective | 21 | 2–9a | 95.2 | 4.8 | - | 4.8 |
Toccaceli et al. [27] (1997) | Retrospective | 36 | 12 | - | 8.2 | - | 0 |
Roig et al. [28] (1999) | Retrospective | 31 | 24b | 90.3 | 3.2 | 3.2 | 24.0 |
Perez et al. [29] (2005) | Prospective | 35 | 32 | 94.3 | 0 | 0 | 12.5 |
Perez et al. [30] (2006) | RCT | 28 | 36 | 92.9 | 0 | 0 | 17.4 |
Jivapaisarnpong [31] (2009) | Prospective | 33 | 14 | 87.9 | - | 6.1 | 0 |
Roig et al. [32] (2010) | Retrospective | 75 | 13 | 89.4 | 1.3 | - | 21.3 |
Kraemer and Picke [33] (2011) | Retrospective | 38 | - | 97.4 | 2.6 | - | 5.3 |
Arroyo et al. [34] (2012) | Retrospective | 70 | 81 | 91.5 | 0 | 1.4 | 16.6 |
Ratto et al. [35] (2013) | Retrospective | 72 | 29.4 | 95.8 | 1.4 | 0 | 11.6 |
Hirschburger et al. [36] (2014) | Retrospective | 50 | 22 | 88.0 | - | - | 6.0 |
Seyfried et al. [37] (2018) | Retrospective | 424 | 11 | 88.2 | 7.5 | - | 23.0 |
Litta et al. [38] (2019) | Retrospective | 203 | 56 | 93.0 | 1.4 | 0 | 13.0 |
Farag et al. [39] (2019) | Retrospective | 175 | 12 | 90.9 | - | - | 2.3 |
De Hous et al. [40] (2021) | Retrospective | 24 | 6b | 95.8 | 25.0 | - | 20.8 |
Aguilar-Martínez et al. [41] (2021) | Retrospective | 107 | 96b | 84.1 | - | - | 14.9 |
Orban et al. [42] (2021) | Retrospective | 24 | 6 | 83.3 | 8.3 | 16.7 | 12.5 |
Jain et al. [43] (2022) | Prospective | 35 | 6 | 88.6 | - | 20 | 5.7 |
This study (2023) | Retrospective | 45 | 2b | 93.3 | 0 | 6.7 | 17.8 |
Characteristic | Group A (n=45) | Group B (n=107) | P-value |
---|---|---|---|
Age (yr) | 46 (26–76) | 45 (22–72) | 0.16 |
Sex | 0.20 | ||
Male | 36 (80.0) | 95 (88.8) | |
Female | 9 (20.0) | 12 (11.2) | |
Type of fistula | <0.01 | ||
Single | 33 (73.3) | 100 (93.5) | |
Multiple | 12 (26.7) | 7 (6.5) | |
Fistula classification | |||
Intersphincteric | 2 (4.4) | 21 (19.6) | 0.02 |
Low to mid transsphincteric | 20 (44.4) | 71 (66.4) | 0.02 |
Mid to high transsphincteric | 17 (37.8) | 11 (10.3) | <0.01 |
Suprasphincteric | 5 (11.1) | 4 (3.7) | 0.13 |
Extrasphincteric | 1 (2.2) | 0 (0) | 0.29 |
Prior incision and drainage | 28 (62.2) | 55 (51.4) | 0.28 |
Prior fistula surgery | 21 (46.7) | 62 (57.9) | 0.22 |
Baseline incontinence | 4 (8.9) | 7 (6.5) | 0.73 |
Gas | 2 (50.0) | 4 (57.1) | |
Liquid and/or solid stool | 2 (50.0) | 3 (42.9) |
Outcome | Group A (n=45) | Group B (n=107) | P-value |
---|---|---|---|
Healing rate | 42 (93.3) | 97 (90.6) | 0.76 |
Postoperative sepsis | 3 (6.7) | 4 (3.7) | 0.42 |
New postoperative incontinence | 8 (17.8) | 15 (14.0) | 0.62 |
Gas | 4 (50.0) | 6 (40.0) | |
Liquid and/or solid stool | 4 (50.0) | 9 (60.0) | |
Follow-up (wk) | 8 (1–77) | 8 (1–170) | 0.89 |
Study | Study type | No. of patients | Mean follow-up (mo) | Healing rate (%) | Sphincter repair dehiscence (%) | Septic complication (%) | Postoperative continence disturbance (%) |
---|---|---|---|---|---|---|---|
Parkash et al. [24] (1985)] | Retrospective | 120 | 6–60 |
96.6 | 11.7 | - | 0 |
Christiansen and Rønholt [25] (1995) | Prospective | 14 | 12–48 |
85.7 | - | - | 21.4 |
Gemsenjäger [26] (1996) | Retrospective | 21 | 2–9 |
95.2 | 4.8 | - | 4.8 |
Toccaceli et al. [27] (1997) | Retrospective | 36 | 12 | - | 8.2 | - | 0 |
Roig et al. [28] (1999) | Retrospective | 31 | 24 |
90.3 | 3.2 | 3.2 | 24.0 |
Perez et al. [29] (2005) | Prospective | 35 | 32 | 94.3 | 0 | 0 | 12.5 |
Perez et al. [30] (2006) | RCT | 28 | 36 | 92.9 | 0 | 0 | 17.4 |
Jivapaisarnpong [31] (2009) | Prospective | 33 | 14 | 87.9 | - | 6.1 | 0 |
Roig et al. [32] (2010) | Retrospective | 75 | 13 | 89.4 | 1.3 | - | 21.3 |
Kraemer and Picke [33] (2011) | Retrospective | 38 | - | 97.4 | 2.6 | - | 5.3 |
Arroyo et al. [34] (2012) | Retrospective | 70 | 81 | 91.5 | 0 | 1.4 | 16.6 |
Ratto et al. [35] (2013) | Retrospective | 72 | 29.4 | 95.8 | 1.4 | 0 | 11.6 |
Hirschburger et al. [36] (2014) | Retrospective | 50 | 22 | 88.0 | - | - | 6.0 |
Seyfried et al. [37] (2018) | Retrospective | 424 | 11 | 88.2 | 7.5 | - | 23.0 |
Litta et al. [38] (2019) | Retrospective | 203 | 56 | 93.0 | 1.4 | 0 | 13.0 |
Farag et al. [39] (2019) | Retrospective | 175 | 12 | 90.9 | - | - | 2.3 |
De Hous et al. [40] (2021) | Retrospective | 24 | 6 |
95.8 | 25.0 | - | 20.8 |
Aguilar-Martínez et al. [41] (2021) | Retrospective | 107 | 96 |
84.1 | - | - | 14.9 |
Orban et al. [42] (2021) | Retrospective | 24 | 6 | 83.3 | 8.3 | 16.7 | 12.5 |
Jain et al. [43] (2022) | Prospective | 35 | 6 | 88.6 | - | 20 | 5.7 |
This study (2023) | Retrospective | 45 | 2b | 93.3 | 0 | 6.7 | 17.8 |
Values are presented as median (range) or number (%). Group A, patients who underwent fistulotomy with immediate primary sphincteroplasty. Group B, patients who underwent fistulotomy without sphincteroplasty.
Values are presented as number (%) or median (range). Group A, patients who underwent fistulotomy with immediate primary sphincteroplasty. Group B, patients who underwent fistulotomy without sphincteroplasty.
FIPS, fistulotomy with immediate primary sphincteroplasty; RCT, randomized controlled trial. Range. Median.