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FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years

2021; Elsevier BV; Volume: 170; Issue: 3 Linguagem: Inglês

10.1016/j.surg.2021.02.055

1532-7361

Francesco Litta, Salvatore Bracchitta, Gabriele Naldini, Massimiliano Mistrangelo, N. Tricomi, Marco La Torre, Donato F. Altomare, Marta Mozzon, A. Testa, Daniele Zigiotto, Giuseppe Sica, Roberta Tutino, Giorgio Lisi, Fabio Marino, Gaetano Luglio, R Vergari, Giovanni Terrosu, Francesco Cantarella, Nicola Foti, Antonio Giuliani, Rossana Moroni, Carlo Ratto, Angelo Parello, Veronica De Simone, Luigi Maria Bracchitta, Alessandro Sturiale, Giacomo Lo Secco, Sara Salomone, L. Velci, Arcangelo Picciariello, Vincenzo Papagni, Filippo Caponnetto, Cristina Folliero, Tiziana Cozza, F Leopardi, Michela Campanelli, Andrea Divizia, Gianfranco Cocorullo, Elio D’Agostino, M. Boccuzzi, Francesco Pezzolla, G Pagano, S Mancini, Monica Ortenzi, Sergio Calandra, Edoardo Scarpa, Enrico Magni, Fabio Cesare Campanile, Lucia Romano, Francesco Maffione, Simone Maria Tierno, Roberto Peltrini,

Colorectal Cancer Surgical Treatments

Background: Surgical treatment of anal fistulas is still a challenge.The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years.Methods: This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003e2017.Surgical techniques were grouped as sphincter-cutting or sphincter-sparing and as technology-assisted or techno-free.All patients included in the study were followed for at least 12 months.Results: A total of 9,536 patients (5,520 simple; 4,016 complex fistulas) entered the study.For simple fistulas, fistulotomy was the most frequently used procedure, although its adoption significantly decreased over the years (P < .0005),with an increase in sphincter-sparing approaches; the overall healing rate in simple fistulas was 81.1%, with a significant difference between sphincter-cutting (91.9%) and sphincter-sparing (65.1%) techniques (P ¼ .001).For complex fistulas, the adoption of