{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:26:53Z","timestamp":1788312413085,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,3,23]],"date-time":"2017-03-23T00:00:00Z","timestamp":1490227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,3,23]],"date-time":"2017-03-23T00:00:00Z","timestamp":1490227200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multiple new procedures for treatment of complex anal fistula have been described in the past decades, but an ideal single technique has yet not been identified. Factors that predict the outcome are required to identify the best procedure for each individual patient. The aim of this study was to find those predictors for advancement flap at midterm follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2012 to 2015\u00a0in a tertiary university clinic, all patients who underwent advancement flap for treatment of complex cryptoglandular fistula were prospectively enrolled. Pre\u2010 and postoperatively standardized anamnestic and clinical examinations were performed. Predictive factors for therapy failure were identified using univariate and multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 65 patients, 61 (93%) completed all examinations and were included in the study. Therapy failure after a mean follow\u2010up period of 25\u00a0months occurred in total <jats:italic>n<\/jats:italic> = 11 patients (18%). There was no significant disturbance of continence among the entire study cohort as shown by the incontinence score (preop 0.34 \u00b1 0.91\u00a0pts., postop 0.37 \u00b1 0.97\u00a0pts.; <jats:italic>p<\/jats:italic> = 0.59). Univariate analysis for risk factors for therapy failure revealed age (<jats:italic>p<\/jats:italic> = 0.004), history of surgical abscess drainage (<jats:italic>p<\/jats:italic> = 0.04), BMI (<jats:italic>p<\/jats:italic> = 0.002), suprasphincteric fistula (<jats:italic>p<\/jats:italic> = 0.019) and horseshoe abscess (<jats:italic>p<\/jats:italic> = 0.036) as independent parameters for therapy failure. During multivariate analysis, only history of surgical abscess drainage (OR = 8.09, <jats:italic>p<\/jats:italic> = 0.048, 95% CI 0.98\u201364.96), suprasphincteric fistula (OR = 6.83, <jats:italic>p<\/jats:italic> = 0.032, 95% CI 1.17\u20136.83) and BMI (OR = 1.23, <jats:italic>p<\/jats:italic> = 0.017, 95% CI 1.03\u20131.46) were independent parameters for therapy failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Advancement flap for treatment of complex fistula is effective and has low risk of disturbed continence. BMI, suprasphincteric fistula and history of surgical abscess drainage are predictors for therapy failure.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4006-7","type":"journal-article","created":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T03:25:10Z","timestamp":1490325910000},"page":"2395-2400","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Advancement Flap for Treatment of Complex Cryptoglandular Anal Fistula: Prediction of Therapy Success or Failure Using Anamnestic and Clinical Parameters"],"prefix":"10.1002","volume":"41","author":[{"given":"Lars","family":"Boenicke","sequence":"first","affiliation":[{"name":"Department of General and Visceral Surgery, Helios University Hospital Wuppertal University Witten\u2010Herdecke Heusnerstra\u00dfe 40 42283 Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Karsten","sequence":"additional","affiliation":[{"name":"Centre of Coloproctology Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Zirngibl","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Helios University Hospital Wuppertal University Witten\u2010Herdecke Heusnerstra\u00dfe 40 42283 Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ambe","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Helios University Hospital Wuppertal University Witten\u2010Herdecke Heusnerstra\u00dfe 40 42283 Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,23]]},"reference":[{"issue":"4","key":"e_1_2_6_2_2","first-page":"219","article-title":"Fistula\u2010in\u2010ano in a defined population. 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