2021
DOI: 10.1007/s10151-020-02385-5
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Simple fistula-in-ano: is it all simple? A systematic review

Abstract: Background Simple anal fistula is one of the most common causes of proctological surgery and fistulotomy is considered the gold standard. This procedure, however, may cause complications. The aim of this systematic review was to assess the surgical treatment of simple anal fistula with traditional and sphincter-sparing techniques. Methods A literature research was performed using PubMed, Cochrane, and Google Scholar to identify studies on the surgical trea… Show more

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Cited by 31 publications
(28 citation statements)
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References 63 publications
(90 reference statements)
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“…This outcome of surgery should be explained to the patient and if is not ready to suffer minor continence problems for an interventional procedure with optimal results, alternative less invasive procedures should be performed. This category of simple fistulas seems to be a very common category of anal fistulas from Park's era with an approximate prevalence of 40-50% of cases reported, despite these simple fistulas are not so simple many times [37] . Therapy with cutting sphincter procedures (fistulotomy) or other sphincter sparing techniques provides excellent surgical results due to simplicity of the fistula.…”
Section: Considerations In Anal Fistula Surgery; the Best Option Ther...mentioning
confidence: 99%
“…This outcome of surgery should be explained to the patient and if is not ready to suffer minor continence problems for an interventional procedure with optimal results, alternative less invasive procedures should be performed. This category of simple fistulas seems to be a very common category of anal fistulas from Park's era with an approximate prevalence of 40-50% of cases reported, despite these simple fistulas are not so simple many times [37] . Therapy with cutting sphincter procedures (fistulotomy) or other sphincter sparing techniques provides excellent surgical results due to simplicity of the fistula.…”
Section: Considerations In Anal Fistula Surgery; the Best Option Ther...mentioning
confidence: 99%
“…As the EAS plays a major role in continence, muscle-dividing procedures like fistulotomy or cutting setons are strictly contraindicated in these fistulas. In fact, fistulotomy with primary sphincter reconstruction or fistulectomy with primary sphincter reconstruction are also best avoided in these patients[ 1 , 12 - 14 ]. Therefore, the choice of procedures becomes limited.…”
Section: Introductionmentioning
confidence: 99%
“…In lay open, incidence of flatus/liquid incontinence occur in 20–25% of cases 11 . Even in simple fistulae, there is evidence that fistulotomy leads to reduced continence over long periods 12 The problem therefore is the realization of a method of treatment that is both highly apt at curing FIA while maintaining the long‐term integrity of the anal sphincter complex.…”
Section: Introductionmentioning
confidence: 99%