Anal fistula plugvs mucosa advancement flap in complex fistula-in-ano:A meta-analysis

AIM:To investigate the efficacy of the anal fistula plug(AFP) compared to the mucosa advancement flap(MAF),considered the best procedure for patients with a complex anal fistula.METHODS:The literature search included PubMed,EMBASE,Cochrane Library and OVID original studies on the topic of AFP compar...

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Veröffentlicht in:世界胃肠外科杂志:英文版(电子版) 2012 (11), p.256-261
1. Verfasser: Qiang Leng Hei-Ying Jin
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description AIM:To investigate the efficacy of the anal fistula plug(AFP) compared to the mucosa advancement flap(MAF),considered the best procedure for patients with a complex anal fistula.METHODS:The literature search included PubMed,EMBASE,Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011.Randomized controlled trials,controlled clinical trials and prospective cohort studies were included in the review.After information collection,a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity.The quality of postoperative life was also included with the clinical results.RESULTS:Six studies involving 408 patients(AFP = 167,MAF = 241) were included in the meta-analysis.The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference(RD) =-0.12,95%CI:-0.39-0.14;RD = 0.13;95%CI:-0.18-0.43,respectively].However,for the AFP,the risk of postoperative impaired continence was lower(RD =-0.08,95%CI:-0.15--0.02) as was the incidence of other complications(RD =-0.06,95%CI:-0.11-0.00).The postoperative quality of life,for patients treated using the AFP was superior to that of the MAF patients.Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced.CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula;it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life.Additional evidence is needed to confirm these findings.
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Jin</creator><creatorcontrib>Qiang Leng Hei-Ying Jin</creatorcontrib><description>AIM:To investigate the efficacy of the anal fistula plug(AFP) compared to the mucosa advancement flap(MAF),considered the best procedure for patients with a complex anal fistula.METHODS:The literature search included PubMed,EMBASE,Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011.Randomized controlled trials,controlled clinical trials and prospective cohort studies were included in the review.After information collection,a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity.The quality of postoperative life was also included with the clinical results.RESULTS:Six studies involving 408 patients(AFP = 167,MAF = 241) were included in the meta-analysis.The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference(RD) =-0.12,95%CI:-0.39-0.14;RD = 0.13;95%CI:-0.18-0.43,respectively].However,for the AFP,the risk of postoperative impaired continence was lower(RD =-0.08,95%CI:-0.15--0.02) as was the incidence of other complications(RD =-0.06,95%CI:-0.11-0.00).The postoperative quality of life,for patients treated using the AFP was superior to that of the MAF patients.Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced.CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula;it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life.Additional evidence is needed to confirm these findings.</description><identifier>ISSN: 1948-9366</identifier><identifier>EISSN: 1948-9366</identifier><language>eng</language><subject>advancement ; anal ; Complex ; fistula ; flap ; Meta-analysis ; Mucosa ; plug</subject><ispartof>世界胃肠外科杂志:英文版(电子版), 2012 (11), p.256-261</ispartof><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/71421X/71421X.jpg</thumbnail><link.rule.ids>314,777,781,4010</link.rule.ids></links><search><creatorcontrib>Qiang Leng Hei-Ying Jin</creatorcontrib><title>Anal fistula plugvs mucosa advancement flap in complex fistula-in-ano:A meta-analysis</title><title>世界胃肠外科杂志:英文版(电子版)</title><addtitle>World Journal of Gastrointestinal Surgery</addtitle><description>AIM:To investigate the efficacy of the anal fistula plug(AFP) compared to the mucosa advancement flap(MAF),considered the best procedure for patients with a complex anal fistula.METHODS:The literature search included 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=-0.06,95%CI:-0.11-0.00).The postoperative quality of life,for patients treated using the AFP was superior to that of the MAF patients.Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced.CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula;it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life.Additional evidence is needed to confirm these findings.</description><subject>advancement</subject><subject>anal</subject><subject>Complex</subject><subject>fistula</subject><subject>flap</subject><subject>Meta-analysis</subject><subject>Mucosa</subject><subject>plug</subject><issn>1948-9366</issn><issn>1948-9366</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNi8sKwjAURIMoWLT_EHAdSGmpxl0RxQ_QdbnEtEbysrct9u_NQsGlM4tzFjMzkmSi2DGRl-X8x5ckRXzwmKIoheAJuVYODG009oMBGszQjkjtID0ChdsITiqrXE8bA4FqR6W3wajX98G0Y-D8vqJW9RAVzIQa12TRgEGVfrgim9PxcjgzefeufWrX1qHTFrqpzjjPY7cR_63ecT5CZg</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Qiang Leng Hei-Ying Jin</creator><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W91</scope><scope>~WA</scope></search><sort><creationdate>2012</creationdate><title>Anal fistula plugvs mucosa advancement flap in complex fistula-in-ano:A meta-analysis</title><author>Qiang Leng Hei-Ying Jin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-chongqing_primary_10030307003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>advancement</topic><topic>anal</topic><topic>Complex</topic><topic>fistula</topic><topic>flap</topic><topic>Meta-analysis</topic><topic>Mucosa</topic><topic>plug</topic><toplevel>online_resources</toplevel><creatorcontrib>Qiang Leng Hei-Ying Jin</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库-医药卫生</collection><collection>中文科技期刊数据库- 镜像站点</collection><jtitle>世界胃肠外科杂志:英文版(电子版)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qiang Leng Hei-Ying Jin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anal fistula plugvs mucosa advancement flap in complex fistula-in-ano:A meta-analysis</atitle><jtitle>世界胃肠外科杂志:英文版(电子版)</jtitle><addtitle>World Journal of Gastrointestinal Surgery</addtitle><date>2012</date><risdate>2012</risdate><issue>11</issue><spage>256</spage><epage>261</epage><pages>256-261</pages><issn>1948-9366</issn><eissn>1948-9366</eissn><abstract>AIM:To investigate the efficacy of the anal fistula plug(AFP) compared to the mucosa advancement flap(MAF),considered the best procedure for patients with a complex anal fistula.METHODS:The literature search included PubMed,EMBASE,Cochrane Library and OVID original studies on the topic of AFP compared to MAF for complex fistula-in-ano that had a deadline for publication by April 2011.Randomized controlled trials,controlled clinical trials and prospective cohort studies were included in the review.After information collection,a meta-analysis was performed using data on overall success rates as well as incidence of incontinence and morbidity.The quality of postoperative life was also included with the clinical results.RESULTS:Six studies involving 408 patients(AFP = 167,MAF = 241) were included in the meta-analysis.The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference(RD) =-0.12,95%CI:-0.39-0.14;RD = 0.13;95%CI:-0.18-0.43,respectively].However,for the AFP,the risk of postoperative impaired continence was lower(RD =-0.08,95%CI:-0.15--0.02) as was the incidence of other complications(RD =-0.06,95%CI:-0.11-0.00).The postoperative quality of life,for patients treated using the AFP was superior to that of the MAF patients.Patients treated with the AFP had less persistent pain of a shorter duration and the healing time of the fistula and hospital stay were also reduced.CONCLUSION:The AFP is an effective procedure for patients with a complex anal fistula;it has the same success rate but a lower risk of complications than the MAF and may also be associated with an improved postoperative quality of life.Additional evidence is needed to confirm these findings.</abstract></addata></record>
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identifier ISSN: 1948-9366
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1948-9366
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source Baishideng "World Journal of" online journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central
subjects advancement
anal
Complex
fistula
flap
Meta-analysis
Mucosa
plug
title Anal fistula plugvs mucosa advancement flap in complex fistula-in-ano:A meta-analysis
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