{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:01:41Z","timestamp":1788494501193,"version":"build-2803163510"},"reference-count":9,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Restorative proctocolectomy has been widely adopted as the procedure of choice for restoring gastrointestinal continuity following proctocolectomy. It is often associated with improved quality of life and high patient satisfaction; however, the development of a pouch anal fistula can cause significant morbidity. Pouch fistulas are notoriously difficult to treat and there is great heterogeneity in the management reported of these fistulas. A lack of classification, and the assumption that fistulas originating from completely different aetiologies will behave and respond similarly to a particular treatment strategy, precludes meaningful comparison of management outcomes. We aim to introduce consistency in the reporting of pouch fistulas using a novel classification system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A consensus process involving clinicians experienced in the management of pouch fistulas from two high volume tertiary centres was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We propose that pouch anal fistulas should be classified into four distinct groups according to their aetiology: group 1, anastomotic related; group 2, inflammatory bowel disease related, with sub\u2010classifications Crohn\u2019s (type A) and non\u2010Crohn\u2019s (type B) in origin; group 3, cryptoglandular related; and group 4, malignancy related.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Classification of pouch fistulas according to their aetiology will provide consistency in the literature and improve the quality of prospective evidence for the management of pouch fistulas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15074","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T05:59:51Z","timestamp":1587189591000},"page":"1436-1439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Perianal fistula and the ileoanal pouch \u2013 different aetiologies require distinct evaluation"],"prefix":"10.1111","volume":"22","author":[{"given":"L. M.","family":"Reza","sequence":"first","affiliation":[{"name":"Fistula Research Unit St Mark\u2019s Hospital and Academic Institute London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. F. C.","family":"Lung","sequence":"additional","affiliation":[{"name":"St Mark\u2019s Hospital and Academic Institute London UK"},{"name":"Department of Surgery and Cancer St Mary\u2019s Hospital Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. L.","family":"Lightner","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. L.","family":"Hart","sequence":"additional","affiliation":[{"name":"St Mark\u2019s Hospital and Academic Institute London UK"},{"name":"Department of Surgery and Cancer St Mary\u2019s Hospital Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Clark","sequence":"additional","affiliation":[{"name":"St Mark\u2019s Hospital and Academic Institute London UK"},{"name":"Department of Surgery and Cancer St Mary\u2019s Hospital Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. J.","family":"Tozer","sequence":"additional","affiliation":[{"name":"Fistula Research Unit St Mark\u2019s Hospital and Academic Institute London UK"},{"name":"Department of Surgery and Cancer St Mary\u2019s Hospital Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6130.85"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14316"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000712"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000094"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-018-1762-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izz005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-014-1197-x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001271"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14814"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15074","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15074","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T08:33:53Z","timestamp":1693730033000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,14]]},"references-count":9,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/codi.15074"],"URL":"https:\/\/doi.org\/10.1111\/codi.15074","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,14]]},"assertion":[{"value":"2019-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}