{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:03:53Z","timestamp":1783649033615,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T00:00:00Z","timestamp":1496361600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Anal fistula causes pain and discharge of pus and blood. Treatment by fistulotomy has the highest success, but can risk continence; treatment needs to balance cure with continence. This study assessed the impact of fistulotomy on quality of life (<jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>) and continence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients selected for fistulotomy prospectively completed the St Mark's Continence Score (full incontinence\u00a0=\u00a024) and Short Form\u201036 questionnaires preoperatively at two institutions with an interest in anal fistula. Patients were reassessed 3\u00a0months\u2019 postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 52 patients with a median age of 44 (range 19\u201382) years; 10 were women. Preoperative continence scores were median 0 (range 0\u201323) and there was no significant difference compared with postoperative scores (median 1, range 0\u201324). Following fistulotomy <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> was significantly improved in four of eight domains \u2013 Bodily Pain (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), Vitality (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01), Social Functioning (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) and Mental Health (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) \u2013 and returned to that of the general population. <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> for patients with intersphincteric fistula improved postfistulotomy, and for those with trans\u2010sphincteric fistula it remained the same. Data were further examined in two groups, with and without deterioration in continence score. Where continence improved postoperatively, <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> improved in three domains; where continence deteriorated <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> improved in two domains (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05). Patients with postoperative continence scores of &lt;\u00a05 had worse <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> than those scoring 4 or less.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content> significantly improved at 3\u00a0months\u2019 follow\u2010up after fistulotomy where continence was maintained or a small reduction occurred.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13538","type":"journal-article","created":{"date-parts":[[2016,10,12]],"date-time":"2016-10-12T17:37:28Z","timestamp":1476293848000},"page":"563-569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Quality of life following fistulotomy \u2013 short term follow\u2010up"],"prefix":"10.1111","volume":"19","author":[{"given":"H. A.","family":"Owen","sequence":"first","affiliation":[{"name":"The Pelvic Floor Unit Department of Surgery Guy's &amp; St Thomas' Hospital London UK"},{"name":"Department of Surgery St Mark's Hospital Harrow UK"},{"name":"Department of Surgery University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. N.","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Surgery St Mark's Hospital Harrow UK"},{"name":"Department of Surgery Charing Cross Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Schizas","sequence":"additional","affiliation":[{"name":"The Pelvic Floor Unit Department of Surgery Guy's &amp; St Thomas' Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"Department of Surgery St Mark's Hospital Harrow UK"},{"name":"Department of Surgery University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Surgery St Mark's Hospital Harrow UK"},{"name":"Department of Surgery University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. B.","family":"Williams","sequence":"additional","affiliation":[{"name":"The Pelvic Floor Unit Department of Surgery Guy's &amp; St Thomas' Hospital London UK"},{"name":"Department of Surgery St Mark's Hospital Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800640203"},{"key":"e_1_2_6_3_1","first-page":"53","article-title":"Fistula\u2010in\u2010ano. A six year follow up study of 143 operated patients","volume":"482","author":"Ewerth S","year":"1978","journal-title":"Acta Chir Scand Suppl"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02617307"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0136"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01648418"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810947"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02054434"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234823"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6181-5"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237236"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237422"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01372.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02554093"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02235039"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9504-1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0755-3"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12224"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01644991"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800770818"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4466"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.44.1.77"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.306.6890.1440"},{"key":"e_1_2_6_24_1","first-page":"40","article-title":"Quality of life in patients undergoing inguinal hernia repair","volume":"79","author":"Lawrence K","year":"1997","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02238022"},{"key":"e_1_2_6_26_1","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s00464-002-9202-2","article-title":"Quality\u2010of\u2010life outcomes with laparoscopic vs open cholecystectomy","volume":"17","author":"Quintana JM","year":"2003","journal-title":"Surg Endosc"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.306.6890.1437"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000352"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236199"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2008.04616.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2006.01036.x"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12090"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v4.i11.251"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1998.00958.x"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-009-0517-z"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13538","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13538","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T13:47:50Z","timestamp":1696340870000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1111\/codi.13538"],"URL":"https:\/\/doi.org\/10.1111\/codi.13538","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]},"assertion":[{"value":"2016-02-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}