Introduction
Materials and methods
Literature review and eligibility criteria
Data extraction
Risk of bias assessment
Data reporting and statistical analysis
Results
Study selection and risk of bias
Authors | Year | Study type | Intervention | Patients | Age (years) | Sex (M:F) | Quality of the studya |
---|---|---|---|---|---|---|---|
Sangwan et al. [13] | 1994 | R | Fistulotomy | 461 | 42 | 310:151 | 8/16 |
Lentner and Wienert [14] | 1996 | R | Long-term indwelling seton | 108 | NR | NR | 6/16 |
Hongo et al. [15] | 1997 | R | Coring out | 319 | NR | NR | 4/16 |
Ho et al. [16] | 1998 | RCT | Fistulotomy | 52 | 41.1 | 49:3 | 3/5 |
Fistulotomy with marsupialization | 51 | 41.2 | 41:10 | ||||
Ho et al. [17] | 2001 | RCT | Chemical ayurvedic seton | 46 | 42 | 21:2 | 3/5 |
Fistulotomy | 54 | 37 | 5:1 | ||||
Isbister and Al Sanea [18] | 2001 | R | Cutting Seton | 31 | 42 | 14.5:1 | 12/16 |
Shahbaz et al. [19] | 2002 | RCT | Fistulectomy | 25 | 32.1 | 24:1 | 1/5 |
Fistulectomy with primary closure | 25 | ||||||
Lindsey et al. [20] | 2002 | RCT | Fistulotomy | 7 | NA | NA | 3/5 |
Chang and Lin [21] | 2003 | P | Fistulotomy | 45 | 54.2 | 29:16 | 14/16 |
Gupta [22] | 2004 | P | Radiofrequency fistulotomy | 232 | NR | NR | 11/16 |
Hammond et al. [23] | 2006 | P | Snug seton | 18 | 42* | 26:3 | 13/16 |
Van Der Hagen et al. [24] | 2006 | P | Fistulotomy | 62 | 40* | 22:9 | 11/16 |
Mahajan et al. [25] | 2007 | P | Fistulectomy and skin graft | 25 | NR | 24:1 | 3/16 |
Van Koperen et al. [26] | 2008 | R | Fistulotomy | 109 | 39 | 71:38 | 14/16 |
Jordàn et al. [27] | 2009 | R | Fistulotomy, fistulectomy | 76 | NA | NA | 12/16 |
Bokhari and Lindsey [28] | 2010 | R | Fistulotomy | 57 | NA | NA | 17/24 |
Bhatti et al. [29] | 2011 | P | Fistulotomy | 25 | NR | 46:4 | 15/24 |
Fistulectomy | 25 | NR | |||||
Sahakitrungruang et al. [30] | 2011 | RCT | Fistulotomy | 25 | 43.2 | 23:2 | 3/5 |
Fistulotomy with marsupialization | 25 | 40.6 | 4:1 | ||||
Nazeer et al. [31] | 2012 | RCT | Fistulectomy | 75 | NR | NR | 3/5 |
Fistulotomy | 75 | NR | NR | ||||
Jain et al. [32] | 2012 | RCT | Fistulectomy | 20 | 34.5 | 4:1 | 3/5 |
Fistulotomy with marsupialization | 20 | 34.3 | 9:1 | ||||
Salem [33] | 2012 | R | Fistulectomy | 146 | NR | 190:82 | 14/24 |
Fistulotomy | 126 | NR | |||||
Kamal [34] | 2012 | RCT | Fistulotomy | 32 | NR | 15:4 | 1/5 |
Fistulectomy | 44 | NR | |||||
Wang et al. [35] | 2012 | RCT | SDPC suture dragging and pad compression | 6 | NA | NA | 3/5 |
Fistulotomy | 5 | NA | NA | ||||
Chalya and Mabula [36] | 2013 | RCT | Fistulectomy | 82 | 37.8 | 76:6 | 3/5 |
Fistulotomy with marsupialization | 80 | 38.6 | 74:6 | ||||
Gottgens et al. [8] | 2015 | R | Fistulotomy | 537 | 45.5 | 379:158 | 12/16 |
Sheikh et al. [37] | 2015 | RCT | Fistulotomy | 131 | 32.5 | All M | 1/5 |
Fistulectomy | 131 | 33.5 | All M | ||||
Visscher et al. [2] | 2015 | R | Fistulotomy | 68 | NA | NA | 13/16 |
Abramowitz et al. [38] | 2016 | P | Fistulotomy | 133 | 48 | 107:133 | 14/16 |
Elsebai et al. [39] | 2016 | P | Fistulectomy | 15 | 35.3 | 23:7 | 21/24 |
Fistulotomy | 15 | 37.4 | |||||
Limongelli et al. [40] | 2016 | P | Fistulotomy | 29 | 41 | 40:13 | 20/24 |
Fistulotomy with marsupialization | 44 | ||||||
Saber [41] | 2016 | RCT | Fistulotomy | 100 | NR | All M | 3/5 |
Fistulectomy | 100 | NR | All M | ||||
Vyas et al. [42] | 2016 | P | Fistulotomy | 38 | 45.2 | 7.3:1 | 17/24 |
Fistulectomy | 37 | ||||||
Wang and Rosen [43] | 2016 | R | Fistulotomy | 26 | 46.4 | 23:3 | 13/16 |
Jayarajah et al. [44] | 2017 | P | Multiple techniques | 34 | 42.5 | 30:14 | 16/16 |
Murtaza et al. [45] | 2017 | R | Fistulotomy | 96 | 40.5 | 81:15 | 21/24 |
Fistulectomy | 96 | 41.4 | 92:4 | ||||
Ganesan et al. [46] | 2017 | RCT | Fistulotomy | 30 | NR | NR | 3/5 |
Fistulectomy | 30 | NR | NR | ||||
Shahid et al. [47] | 2017 | RCT | Fistulectomy | 30 | 35.8 | 4:1 | 3/5 |
Fistulectomy and suture | 30 | 38.4 | 13:1 | ||||
Vyas et al. [48] | 2017 | P | Fistulotomy | 92 | 38.5 | 85:7 | 8/16 |
Mittal et al. [49] | 2018 | RCT | Fistulotomy | 38 | 41.5 | 31:6 | 3/5 |
Fistulectomy | 37 | 45.2 | 35:3 | ||||
Gupta et al. [50] | 2018 | RCT | Fistulectomy | 30 | 35.5 | 28:2 | 1/5 |
Mallik et al [51] | 2018 | P | Fistulotomy | 25 | 39.6 | 23:2 | 13/24 |
Fistulectomy | 25 | 24:1 | |||||
Anan et al. [52] | 2019 | RCT | Fistulotomy | 30 | 38.3 | 4:1 | 5/5 |
Fistulotomy with marsupialization | 30 | 43.5 | 13:2 | ||||
Bhatia [53] | 2019 | P | Fistulectomy | 50 | NR | > 2:1 | 12/16 |
Sahai et al. [54] | 2019 | RCT | Fistulotomy | 28 | 41 | 5:1 | 1/5 |
Sanad et al. [55] | 2019 | RCT | Fistulotomy + phenytoin 2% and sitz baths | 30 | 41.4 | 5:1 | 5/5 |
Fistulotomy + sitz baths | 30 | ||||||
Basa and Prakash [56] | 2020 | P | Open Fistulectomy | 25 | NR | 2:1 | 21/24 |
Fistulectomy with primary closure | 25 | NR | |||||
De Hous et al. [57] | 2020 | R | Fistulectomy and suture | 24 | 52.8 | 2:1 | 14/16 |
Total | 4883 |
Authors | Year | Study type | Intervention | Patients (no.) | Age (years) | Sex (M:F) | Quality of the studya |
---|---|---|---|---|---|---|---|
Cintron et al [58] | 2000 | P | Fibrin glue | 11 | NA | NA | 19/24 |
Lindsey et al [20] | 2002 | RCT | Fibrin glue | 6 | NA | NA | 3/5 |
Mohammed [59] | 2004 | P | Laser | 6 | 32 | All M | 11/16 |
Gisbertz et al [60] | 2005 | P | Fibrin glue | 27 | 43 | 23:4 | 13/16 |
Barillari et al [61] | 2006 | P | Cyanoacrylate glue | 7 | NA | NA | 13/16 |
Rojanasakul et al [62] | 2007 | P | LIFT | 13 | NA | NA | 12/16 |
Chew and Adams [63] | 2007 | R | Advancement flap | 6 | 46 | 2:1 | 11/16 |
Jain et al [64] | 2008 | P | Cyanoacrylate glue | 20 | 26 | 3:1 | 12/16 |
Bokhari and Lindsey [28] | 2010 | R | Flap and glue | 9 | NA | NA | 17/24 |
Mishra et al [65] | 2013 | P | Fibrin glue | 16 | NA | NA | 11/16 |
Van Onkelen et al [66] | 2013 | R | LIFT | 22 | 45.5 | 13:9 | 14/16 |
Oztürk and Gülcü [67] | 2014 | R | Laser | 44 | NR | NR | 13/16 |
Cestaro et al [68] | 2014 | P | Fibrin glue | 6 | NR | NR | 12/16 |
Malakorn et al [69] | 2017 | R | LIFT | 167 | NR | NR | 13/16 |
Wilhelm et al [70] | 2017 | P | Laser | 8 | NA | NA | 13/16 |
Gupta et al [50] | 2018 | RCT | SLOFT | 30 | 33.5 | 23:7 | 1/5 |
Giordano et al [71] | 2018 | P | Permacol paste | 27 | NA | NA | 12/16 |
Terzi et al [72] | 2018 | R | Laser | 61 | NA | NA | 15/16 |
Marinello et al [73] | 2018 | R | OTSC clip | 3 | 58.3 | All F | 9/16 |
Bayrak et al [74] | 2018 | P | Permacol paste | 11 | NA | NA | 11/16 |
Sahai et al [54] | 2019 | RCT | LIFT | 22 | 41 | 5:1 | 1/5 |
Iqbal et al [75] | 2019 | P | 1% silver nitrate | 76 | 32 | 31:7 | 11/16 |
Vander Mijnsbrugge et al [76] | 2019 | P | LIFT | 4 | NA | NA | 15/16 |
Total | 602 |
Patient characteristics and surgical procedures
Perioperative details
Authors | Technique | Operation time (minutes) | Hospital stay (days) | Healing time (days) | Morbidity (no. %) | |||
---|---|---|---|---|---|---|---|---|
Bleeding | Urinary retention | Infection | Other | |||||
Lentner and Wienert | Long term indwelling seton | NR | 0.3 | NR | NR | NR | NR | NR |
Ho et al | Fistulotomy | 8.0 | 2.0 | 42.0 | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Ho et al | Fistulotomy with marsupialization | 10.0 | 1.0 | 70.0 | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Ho et al | Chemical ayurvedic seton | NR | 1* | 54* | 0 (0) | 0 (0) | 1 (2.2) | 0 (0) |
Ho et al | Fistulotomy | NR | 1* | 45* | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Isbister and Al Sanea | Cutting Seton | NR | NR | 183.0 | NR | NR | NR | 0 (0) |
Shahbaz et al | Fistulectomy | NR | NR | 31.8 | NR | NR | NR | 0 (0) |
Shahbaz et al | Fistulectomy with primary closure | NR | NR | 8.0 | NR | NR | NR | 0 (0) |
Lindsey et al | Fistulotomy | NA | NA | NA | NA | NA | NA | 0 (0) |
Gupta | Radiofrequency fistulotomy | 13.0 | 0 | 67.0 | 0 (0) | 0 (0) | 0 (0) | 1 (0.4) |
Hammond et al | Snug seton | NA | NA | NA | NR | NR | 1 (5.6) | 2 (11.1) |
Mahajan et al | Fistulectomy and skin graft | 41.2 | 9.2 | 13.8 | NR | NR | NR | NR |
Van Koperen et al | Fistulotomy | NR | NR | NR | 1 (0.9) | 0 (0) | 1 (0.9) | 0 (0) |
Bhatti et al | Fistulotomy | NR | 1.5 | 24* | 1 (4) | 0 (0) | 0 (0) | 0 (0) |
Bhatti et al | Fistulectomy | NR | 2.5 | 35* | 3 (12) | 0 (0) | 0 (0) | 0 (0) |
Sahakitrungruang et al | Fistulotomy | NR | NR | NR | 2 (8) | 2 (8) | 1 (4) | 0 (0) |
Sahakitrungruang et al | Fistulotomy with marsupialization | NR | NR | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Nazeer et al | Fistulectomy | NR | 3.5 | 40.0 | 5 (6.7) | 0 (0) | 0 (0) | 0 (0) |
Nazeer et al | Fistulotomy | NR | 2.0 | 28.0 | 1 (1.3) | 0 (0) | 0 (0) | 0 (0) |
Jain et al | Fistulectomy | 28.0 | NR | 47.3 | NR | NR | NR | NR |
Jain et al | Fistulotomy with marsupialization | 28.2 | NR | 34.0 | NR | NR | NR | NR |
Salem | Fistulectomy | NR | 2.0 | 21.0 | NR | NR | NR | NR |
Salem | Fistulotomy | NR | 3.0 | 28.0 | NR | NR | NR | NR |
Kamal | Fistulotomy | 17.3 | NR | 26.4 | 0 (0) | 0 (0) | 1 (3.1) | 0 (0) |
Kamal | Fistulectomy | 33.0 | NR | 38.6 | 1 (2.3) | 0 (0) | 1 (2.3) | 0 (0) |
Chalya e Mabula | Fistulectomy | 28.4 | 3.9 | 36.4 | 0 (0) | 0 (0) | 27 (32.9) | 0 (0) |
Chalya e Mabula | Fistulotomy with marsupialization | 29.2 | 4.2 | 28.6 | 0 (0) | 0 (0) | 28 (35) | 0 (0) |
Gottgens et al | Fistulotomy | NR | NR | 37* | NR | NR | NR | NR |
Sheikh et al | Fistulotomy | 14.3 | 3.7 | 28.8 | 1 (0.8) | NR | 3 (2.3) | NR |
Skeikh et al | Fistulectomy | 25.9 | 4.9 | 32.0 | 4 (3.1) | NR | 5 (3.8) | NR |
Abramowitz et al | Fistulotomy | NR | NR | 56* | 1 (0.8) | 0 (0) | 0 (0) | 0 (0) |
Elsebai et al | Fistulectomy | 40.7 | NR | 45.3 | 0 (0) | 2 (13.3) | 1 (6.7) | NR |
Elsebai et al | Fistulotomy | 19.4 | NR | 28.5 | 0 (0) | 1 (6.7) | 2 (13.3) | NR |
Limongelli et al | Fistulotomy | NR | NR | NR | 14 (48.3) | NR | NR | NR |
Limongelli et al | Fistulotomy with marsupialization | NR | NR | NR | 7 (15.9) | NR | NR | NR |
Saber | Fistulotomy | 27.0 | 1.0 | 30.0 | NR | NR | NR | NR |
Saber | Fistulectomy | 37.0 | 1.0 | 41.7 | NR | NR | NR | NR |
Vyas et al | Fistulotomy | NR | 2.9 | 28.6 | NR | NR | 4 (10.5) | NR |
Vyas et al | Fistulectomy | NR | 4.3 | 48.5 | NR | NR | 15 (40.5) | NR |
Murtaza et al | Fistulotomy | 17* | NR | 15* | NR | NR | NR | NR |
Murtaza et al | Fistulectomy | 25* | NR | 30* | NR | NR | NR | NR |
Ganesan et al | Fistulotomy | 12.1 | 1.8 | 24.2 | 0 (0) | 3 (10.0) | 1 (3.3) | NR |
Ganesan et al | Fistulectomy | 22.2 | 2.6 | 31.5 | 2 (6.7) | 5 (16.7) | 3 (10) | NR |
Vyas et al | Fistulotomy | NR | NR | 28.0 | NR | NR | 7 (7.7) | NR |
Mittal et al | Fistulotomy | NR | 2.9 | 28.6 | NR | NR | 4 (10.5) | NR |
Mittal et al | Fistulectomy | NR | 4.3 | 48.5 | NR | NR | 15 (40.5) | NR |
Gupta et al | Fistulectomy | 43.0 | NR | 32.0 | NR | NR | 2 (6.7) | NR |
Mallik et al | Fistulotomy | 9.7 | 3.9 | 16.8 | NR | 0 (0) | NR | NR |
Mallik et al | Fistulectomy | 15.2 | 4.2 | 24.4 | NR | 0 (0) | NR | NR |
Anan et al | Fistulotomy | 16.8 | NR | 46.9 | 2 (6.7) | 1 (3.3) | 0 (0) | 0 (0) |
Anan et al | Fistulotomy with marsupialization | 18.4 | NR | 35.7 | 0 (0) | 2 (6.7) | 0 (0) | 0 (0) |
Bhatia | Fistulectomy | 26.4 | 2.0 | 39.0 | 3 (6) | 6 (12) | 0 (0) | 6 (12) |
Sanad et al | Fistulotomy + phenytoin 2% and sitz baths | 13.0 | 0 | 41.2 | 3 (10) | 1 (3.3) | 0 (0) | 0 (0) |
Sanad et al | Fistulotomy + sitz baths | 14.0 | 0 | 42.0 | 2 (6.7) | 1 (3.3) | 0 (0) | 0 (0) |
Basa and Prakash | Fistulectomy | NR | 1.0 | 31.0 | 0 (0) | 10 (40) | 0 (0) | 0 (0) |
Basa and Prakash | Fistulectomy with primary closure | NR | 7.0 | 8.0 | 0 (0) | 6 (24) | 0 (0) | 0 (0) |
De Hous et al | Fistulectomy and suture | 20* | 0 | NR | 0 (0) | NR | 0 (0) | 6 (25) |
Total | 53 (2.9) | 40 (2.6) | 123 (6) | 15 (4) | ||||
Weighted average | 21.9 | 3.1 | 41.0 |
Authors | Technique | Operation time (minutes) | Hospital stay (days) | Healing time (days) | Morbidity (no. %) | |||
---|---|---|---|---|---|---|---|---|
Bleeding | Urinary retention | Infection | Other | |||||
Lindsey et al | Fibrin glue | NA | NA | NA | NA | NA | NA | 1 (16.7) |
Mohammed | Laser | 19.0 | 0 | 7.7 | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Gisbertz et al | Fibrin glue | 20.0 | NR | NA | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Barillari et al | Cyanoacrylate glue | NR | NR | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Rojanasakul et al | LIFT | 40 | 1.3 | 28.0 | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Chew e Adams | Advancement flap | 52.5 | 1.0 | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Jain et al | Cyanoacrylate glue | NR | 0.0 | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Mishra et al | Fibrin glue | NA | NA | NA | 0 (0) | 0 (0) | 0 (0) | 1 (6.3) |
Oztürk and Gulcü | Laser | NR | 1.5 | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Cestaro et al | Fibrin glue | NR | 1.0 | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Gupta et al | SLOFT | 46.0 | NR | 11.0 | 0 (0) | 0 (0) | 1 (3.3) | 0 (0) |
Marinello et al | OTSC clip | 21.7 | NR | NR | 0 (0) | 0 (0) | 0 (0) | 3 (100) |
Iqbal et al | 1% silver nitrate | NR | NR | NR | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Vander Mijnsbrugge et al | LIFT | NA | NA | NA | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Total | 0 (0) | 0 (0) | 1 (0.004) | 5 (0.02) | ||||
Weighted average | 34.5 | 0.8 | 15.1 |
Success rate and continence status
Author | Technique | Follow-up (months) | Success (%) | Preoperative continence impairment (%) | Postoperative continence impairment (%) | |||
---|---|---|---|---|---|---|---|---|
Any impairment | Incontinence to liquid | Incontincence to gas | Major incontinence | |||||
Sangwan et al | Fistulotomy | 34.0 | 93.5 | NR | NA | 2.8 | NR | 0.0 |
Lentner and Wienert | Long term Indwelling seton | 15.6 | 88.0 | 0 | 1 | 0 | 1 | 0.0 |
Hongo et al | Coring out | NR | 98.7 | NR | 6.4 | NR | NR | NR |
Ho et al | Fistulotomy | 9.0 | 96.0 | NR | 12.0 | NR | NR | NR |
Ho et al | Fistulotomy with marsupialization | 10.2 | 98.0 | NR | 2.0 | NR | NR | NR |
Ho et al | Chemical ayurvedic seton | 2.3* | 97.8 | NR | 10.9 | 6.5 | 4.3 | 0.0 |
Ho et al | Fistulotomy | 1.9* | 98.2 | NR | 5.6 | 3.7 | 1.9 | 0.0 |
Isbister and Al Sanea | Cutting seton | 13 | 96.8 | NA | 7.1 | 0 | 7.1 | 0 |
Shahbaz et al | Fistulectomy | NR | 88.0 | NR | 12.0 | NR | 12.0 | NR |
Shahbaz et al | Fistulectomy with primary closure | NR | 92.0 | NR | NR | NR | NR | NR |
Lindsey et al | Fistulotomy | 18 | 100.0 | NA | 0 | 0 | 0 | 0 |
Chang and Lin | Fistulotomy | 9.5 | 100.0 | NR | 38 | NR | NR | NR |
Gupta | Radiofrequency fistulotomy | 15.0 | 99.2 | NR | 0 | 0 | 0 | 0 |
Hammond et al | Snug seton | NA | 100.0 | 0 | 25.0 | 0 | 25.0 | 0 |
Van Der Hagen et al | Fistulotomy | 75* | 61.0 | 4.8 | 9.7 | 0 | 0 | 0 |
Van Koperen et al | Fistulotomy | 77* | 93.0 | 2.8 | 41.0 | NR | NR | 4.8 |
Jordàn et al | Fistulotomy, fistulectomy | 19.2 | 97.4 | NA | 8.1 | NA | NA | NA |
Bokhari and Lindsey | Fistulotomy | NR | 93.0 | NR | 16.0 | NR | 11.0 | 5.0 |
Bhatti et al | Fistulotomy | NR | 100.0 | NR | 0 | 0 | 0 | 0 |
Bhatti et al | Fistulectomy | NR | 100.0 | NR | 0 | 0 | 0 | 0 |
Sahakitrungruang et al | Fistulotomy | NR | 100.0 | NR | 0 | 0 | 0 | 0 |
Sahakitrungruang et al | Fistulotomy with marsupialization | NR | 100.0 | NR | 0 | 0 | 0 | 0 |
Nazeer et al | Fistulectomy | 10.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Nazeer et al | Fistulotomy | 10.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Jain et al | Fistulectomy | 3.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Jain et al | Fistulotomy with marsupialization | 3.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Salem | Fistulectomy | 12 | 94.0 | NR | NR | NR | NR | NR |
Salem | Fistulotomy | 12 | 90.0 | NR | NR | NR | NR | NR |
Kamal | Fistulotomy | 12.0 | 93.7 | NR | 6.3 | 0 | 6.3 | 0 |
Kamal | Fistulectomy | 12.0 | 93.2 | NR | 11.4 | 0 | 11.4 | 0 |
Wang et al | SDPC suture dragging and pad compression | 12 | 96.7 | 0 | 0.0 | NA | NA | NA |
Wang et al | Fistulotomy | 12 | 100.0 | 0 | 1.0 | NR | NR | NR |
Chalya and Mabula | Fistulectomy | 3.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Chalya and Mabula | Fistulotomy with marsupialization | 3.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Gottgens et al | Fistulotomy | 38.9* | 83.6 | 1.3 | 45.7 | NA | NA | 28.0 |
Sheikh et al | Fistulotomy | 6 | 89.3 | NR | NR | NR | NR | NR |
Skeikh et al | Fistulectomy | 6 | 84.7 | NR | NR | NR | NR | NR |
Visscher et al | Fistulotomy | NA | 84.0 | NR | 27.9 | 3.0 | 24.0 | 3.0 |
Abramowitz et al | Fistulotomy | 12.0 | 99.2 | NR | NA | NA | NA | NA |
Elsebai et al | Fistulectomy | 8.0 | 100.0 | 0.0 | 6.7 | 0.0 | 6.7 | 0.0 |
Elsebai et al | Fistulotomy | 8.0 | 100.0 | 0.0 | 13.3 | 0.0 | 13.3 | 0.0 |
Limongelli et al | Fistulotomy | 39.4 | 96.6 | NR | NR | NR | NR | NR |
Limongelli et al | Fistulotomy with marsupialization | 39.4 | 95.5 | NR | NR | NR | NR | NR |
Saber | Fistulotomy | NR | 98.0 | NR | 2.0 | NA | NA | NA |
Saber | Fistulectomy | NR | 100.0 | NR | 4.0 | NA | NA | NA |
Vyas et al | Fistulotomy | NR | 94.7 | NR | 0 | NA | NA | NA |
Vyas et al | Fistulectomy | NR | 81.1 | NR | 0 | NA | NA | NA |
Wang e Rosen | Fistulotomy | 11.9 | 100.0 | NR | NR | 0 | NA | 0 |
Jayarajah et al | Multiple techniques | 27.5 | NR | 18.0 | 38.0 | NR | NR | NR |
Murtaza et al | Fistulotomy | 6.0 | 96.9 | NR | 5.3 | NR | NR | NR |
Murtaza et al | Fistulectomy | 6.0 | 95.8 | NR | 12.5 | NR | NR | NR |
Ganesan et al | Fistulotomy | 8.0 | 96.7 | NR | 1.0 | 0.0 | 6.7 | 0.0 |
Ganesan et al | Fistulectomy | 8.0 | 100.0 | NR | 0.0 | 3.3 | 13.3 | 0.0 |
Shahid et al | Fistulectomy | 1.5 | 93.3 | NR | NR | NR | NR | NR |
Shahid et al | Fistulectomy and suture | 1.5 | 100.0 | NR | NR | NR | NR | NR |
Vyas et al | Fistulotomy | NR | 96.8 | NR | 0.0 | NR | NR | NR |
Mittal et al | Fistulotomy | NR | 94.7 | NR | 0 | 0 | 0 | 0 |
Mittal et al | Fistulectomy | NR | 81.1 | NR | 0 | 0 | 0 | 0 |
Gupta et al | Fistulectomy | NR | 100.0 | NR | 3.3 | NR | NR | NR |
Mallik et al | Fistulotomy | 18.0 | 96.0 | NR | 0 | 0 | 0 | 0 |
Mallik et al | Fistulectomy | 18.0 | 100.0 | NR | 0 | 0 | 0 | 0 |
Anan et al | Fistulotomy | 11.3 | 96.7 | NR | 3.3 | 0 | 3.3 | 0 |
Anan et al | Fistulotomy with marsupialization | 11.5 | 100.0 | NR | 0 | 0 | 0 | 0 |
Bhatia | Fistulectomy | NR | 96.0 | NR | 8.0 | 0 | 8.0 | 0 |
Sahai et al | Fistulotomy | 2–6 | 86.0 | NR | 0 | NA | NA | NA |
Sanad et al | Fistulotomy + phenytoin 2% and sitz baths | 8.2 | 100.0 | NR | 0 | NA | NA | NA |
Sanad et al | Fistulotomy + Sitz baths | 7.6 | 100.0 | NR | 0 | NA | NA | NA |
Basa and Prakash | Open Fistulectomy | 1 | 96.0 | NR | 0 | NA | NA | NA |
Basa and Prakash | Fistulectomy with primary closure | 1 | 100.0 | NR | 0 | NA | NA | NA |
De Hous et al | Fistulectomy and suture | 3* | 95.8 | NR | 20.8 | NR | NR | NR |
Weighted average | 14.7 | 93.7 | 2.1 | 12.7 | 1.1 | 3.7 | 6.0 |
Author | Technique | Follow-up (months) | Success (%) | Preoperative continence impairment (%) | Postoperative continence impairment (%) | |||
---|---|---|---|---|---|---|---|---|
Any impairment | Incontinence to liquid | Incontincence to gas | Major incontinence | |||||
Cintron et al | Fibrin glue | NA | 82.0 | NR | NR | NR | NR | NR |
Lindsey et al | Fibrin glue | NA | 50.0 | NA | 0 | 0 | 0 | 0 |
Mohammed | Laser | 2.3 | 100.0 | NR | 0 | 0 | 0 | 0 |
Gisbertz et al | Fibrin glue | 6.8* | 33.0 | 7.4 | 0 | 0 | 0 | 0 |
Barillari et al | Cyanoacrylate glue | 18.0 | 71.4 | 0 | 0 | 0 | 0 | 0 |
Rojanasakul et al | LIFT | NR | 94.4 | NR | 0 | 0 | 0 | 0 |
Chew e Adams | Advancement flap | 8.1 | 98.0 | 0 | 0 | 0 | 0 | 0 |
Jain et al | Cyanoacrylate glue | 6.0 | 95.0 | 0 | 0 | 0 | 0 | 0 |
Bokhari and Lindsey | Flap and glue | NR | 60.0 | NR | 11.1 | 0 | 11.1 | 0 |
Mishra et al | Fibrin glue | NA | 81.0 | NA | 0 | 0 | 0 | 0 |
Oztürk e Gülcü | Laser | NA | 86.4 | NR | NR | NR | NR | NR |
Cestaro et al | Fibrin glue | 12 | 66.7 | NR | 0 | 0 | 0 | 0 |
Van Onkelen et al | LIFT | 19.9* | 82.0 | 0 | 0 | 0 | 0 | 0 |
Malakorn et al | LIFT | 71* | 91.0 | NR | 0 | 0 | 0 | 0 |
Wilhelm et al | Laser | NA | 100.0 | NA | 0 | 0 | 0 | 0 |
Gupta et al | SLOFT | NR | 100.0 | NR | 0 | 0 | 0 | 0 |
Giordano et al | Permacol paste | 12 | 70.4 | NA | NA | NA | NA | NA |
Terzi et al | Laser | 28.3 | 39.0 | NR | 0 | 0 | 0 | 0 |
Marinello et al | OTSC clip | 22.7 | 100.0 | NR | NR | NR | NR | NR |
Bayrak et al | Permacol paste | 12 | NA | NA | 0 | 0 | 0 | 0 |
Sahai et al | LIFT | 2–6 | 68.2 | NR | 0 | 0 | 0 | 0 |
Iqbal et al | 1% silver nitrate | 2.5 | 76.3 | NR | NR | NR | NR | NR |
Vander Mijnsbrugge et al | LIFT | 45 | 25.0 | NA | 0 | 0 | 0 | 0 |
Weighted average | 13.2 | 77.7 | 2.4 | 0.2 | 0 | 0.2 | 0 |