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Studies comparing outcomes with the <jats:styled-content style=\"fixed-case\">AFP <\/jats:styled-content><jats:italic>vs <\/jats:italic><jats:styled-content style=\"fixed-case\">RAF<\/jats:styled-content> for complex cryptoglandular anal fistulas were eligible for inclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 11 articles with 810 patients were included in this meta\u2010analysis. Four RCTs and one observational clinical study provided long\u2010term follow\u2010up. The pooled analysis of all 11 studies indicated that there was no significant difference between the <jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">RAF<\/jats:styled-content> in terms of healing rate, recurrence rate and incidence of fistula complications. However, the pooled results of studies with long\u2010term follow\u2010up revealed that the <jats:styled-content style=\"fixed-case\">RAF<\/jats:styled-content> group had a significantly higher healing rate (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.32, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.13, 0.78, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and lower recurrence rate (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 4.45, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.45, 13.65, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009) than the <jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content> group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For the treatment of complex cryptoglandular anal fistulas, the <jats:styled-content style=\"fixed-case\">RAF<\/jats:styled-content> was superior to the <jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content> in terms of healing and recurrence rate after pooling of randomized controlled trials with long\u2010term follow\u2010up, even though a comparison based on the pooling of all studies showed no significant difference.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14504","type":"journal-article","created":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T01:59:08Z","timestamp":1543629548000},"page":"502-515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Anal fistula plug <i>vs<\/i> rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a systematic review and meta\u2010analysis of studies with long\u2010term follow\u2010up"],"prefix":"10.1111","volume":"21","author":[{"given":"H.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit Affiliated Hangzhou First People's Hospital Zhejiang University 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