Long-term healing after complex anal fistula repair in patients with Crohn’s disease

Mujukian, Angela; Truong, Adam; Fleshner, Phillip; Zaghiyan, Karen

doi:10.1007/s10151-020-02238-1

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…Of these, 166 were included in the full text review. Seventy‐six were further excluded, leaving 90 studies for data extraction [17–106] (Figure 1). Of the 90 studies, there were 53 retrospective studies, 16 prospective observational studies, 16 RCTs, four case series and one cross‐sectional study.…”

Section: Resultsmentioning

confidence: 99%

The use of core descriptors from the ENiGMA code study in recent literature: a systematic review

Khan,

Arline,

Williams

et al. 2024

Colorectal Disease

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AimThe heterogeneity in data quality presented in studies regarding Crohn's anal fistula (CAF) limit extrapolation into clinical practice. The ENiGMA collaborators established a core descriptor set to standardize reporting of CAF. The aim of this work was to quantify the use of these descriptors in recent literature.MethodWe completed a systematic review of PubMed and the Cochrane Library, extracting publications from the past 10 years specific to the clinical interventions and outcomes of CAF, and reported in line with PRISMA guidance. Each article was assessed for inclusion of ENiGMA descriptors. The median number of descriptors per publication was evaluated along with the overall frequency of each individual descriptor. Use of ENiGMA descriptors was compared between medical and procedural publications.ResultsNinety publications were included. The median number of descriptors was 15 of 37; 16 descriptors were used in over half of the publications while 17 were used in fewer than a third. Descriptors were more frequently used in procedural (n = 16) than medical publications (n = 14) (p = 0.031). In procedural publications, eight descriptors were more frequently used including Faecal incontinence, Number of previous fistula interventions, Presence and severity of anorectal stenosis and Current proctitis. Medical publications were more likely to include Previous response to biological therapy and Duration and type of current course of biological therapy.ConclusionWith many descriptors being used infrequently and variations between medical and procedural literature, the colorectal community should assess the need for all 37 descriptors.

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Section: Resultsmentioning

confidence: 99%

The use of core descriptors from the ENiGMA code study in recent literature: a systematic review

Khan,

Arline,

Williams

et al. 2024

Colorectal Disease

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“…This is a comparative study on this subject. In the past, most studies dealt with either only CD patients or only cryptoglandular fistulas [ 4 , 22 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Healing of rectal advancement flaps for anal fistulas in patients with and without Crohn’s disease: a retrospective cohort analysis

et al. 2021

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Background Surgical closure of anal fistulas with rectal advancement flaps is an established standard method, but it has a high degree of healing failure in some cases. The aim of this study was to identify risk factors for anal fistula healing failure after advancement flap placement between patients with cryptoglandular fistulas and patients with Crohn’s disease (CD). Methods From January 2010 to October 2020, 155 rectal advancement flaps (CD patients = 55, non-CD patients = 100) were performed. Patients were entered into a prospective database, and healing rates were retrospectively analysed. Results The median follow-up period was 189 days (95% CI: 109–269). The overall complication rate was 5.8%. The total healing rate for all rectal advancement flaps was 56%. CD patients were younger (33 vs. 43 years, p < 0.001), more often female (76% vs. 30%, p < 0.001), were administered more immunosuppressant medication (65% vs. 5%, p < 0.001), and had more rectovaginal fistulas (29% vs. 8%, p = 0.001) and more protective stomas (49% vs. 2%, p < 0.001) than patients without CD. However, no difference in healing rate was noted between patients with or without CD (47% vs. 60%, p = 0.088). Conclusions Patients with anal fistulas with and without Crohn’s disease exhibit the same healing rate. Although patients with CD display different patient-specific characteristics, no independent factors for the occurrence of anal fistula healing failure could be determined. Trial registration Not applicable due to the retrospective study design.

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“…This is a comparative study on this subject. In the past, most studies dealt with either only CD patients or only cryptoglandular stulas 7,24,27 .…”

Section: Discussionmentioning

confidence: 99%

Healing of rectal advancement flap for anal fistula in patients with and without Crohn’s disease: a retrospective cohort analysis

Seifarth

Lehmann

Holmer

et al. 2021

Preprint

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Background Surgical closure of anal fistulas with rectal advancement flap is an established standard method, but in some cases, it has a high degree of healing failure. There are few studies in literature with a small number of cases examining differences between patients with and without Crohn's disease (CD). The aim of this study was to identify risk factors for anal fistula healing failure after advancement flap between patients with cryptoglandular fistulas and patients with CD. Methods From January 2010 to October 2020, 155 rectal advancement flaps (CD patients = 55, non-CD patients = 100) were performed. Patients were entered into a prospective database and retrospectively analyzed for healing rates. Results Median follow up was 189 days (95 % CI: 109–269). Overall complication rate was 5.8 %. Total healing rate for all rectal advanced flaps was 56 %. CD patients were younger (33 vs. 43 years, p < 0.001), more often female (76 vs. 30 %, p < 0.001), had more immunosuppressant medication (65 vs. 5 %, p < 0.001), more vaginal fistulas (29 vs. 8 %, p = 0.001) and more protective stomas (49 vs. 2 %, p < 0.001) than patients without CD. However, there was no difference in the healing rate of patients with or without CD (47 % vs. 60 %, p = 0.088). Conclusions Patients with anal fistulas without and with Crohn’s disease have the same healing rate. Although patients with CD differ in their patient-specific characteristics, no independent factors for the occurrence of anal fistula healing failure could be determined. Trial registration: Not applicable due to the retrospective study design.

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Long-term healing after complex anal fistula repair in patients with Crohn’s disease

Cited by 10 publications

References 23 publications

The use of core descriptors from the ENiGMA code study in recent literature: a systematic review

The use of core descriptors from the ENiGMA code study in recent literature: a systematic review

Healing of rectal advancement flaps for anal fistulas in patients with and without Crohn’s disease: a retrospective cohort analysis

Healing of rectal advancement flap for anal fistula in patients with and without Crohn’s disease: a retrospective cohort analysis

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