{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:50:45Z","timestamp":1787237445851,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"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":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Treatment of complex fistula\u2010in\u2010ano is challenging and there is no consensus on the optimal treatment that can provide complete healing and preserve sphincter function. The aim of this study was to evaluate fistulotomy with external tract fistulectomy and primary sphincter reconstruction (FFSR) in the treatment of high trans\u2010sphincteric fistula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This is a prospective single\u2010centre study including patients with a high trans\u2010sphincteric fistula who underwent FFSR from June 2017 to June 2018. All patients were evaluated preoperatively by pelvic MRI and clinical examination. Other types of complex fistula were excluded. All patients were followed up for 1\u00a0year for recurrence and incontinence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty patients underwent FFSR during the study period, 62.5% were men and the mean age was 37.45 (range 20\u201360)\u00a0years. The mean time to achieve complete healing was 8.4\u2009weeks, 35 (87.5%) patients achieved primary healing within 8\u2009weeks and 5 (12.5%) patients required more time to achieve delayed healing. Four (10%) patients developed recurrence with a mean time for recurrence of 20\u2009weeks. Only four (10%) patients developed incontinence; one to liquid stools and three patients only to gas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fistulotomy with external tract fistulectomy and primary sphincter reconstruction is a safe option in the treatment of high trans\u2010sphincteric fistula in selected patients. This showed an acceptable recurrence rate when compared with other procedures with comparable sphincter function outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.16532","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T07:28:19Z","timestamp":1676964499000},"page":"1208-1212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cohort study of fistulotomy with external tract fistulectomy and primary sphincter reconstruction in high trans\u2010sphincteric\n                    <scp>fistula\u2010in\u2010ano<\/scp>"],"prefix":"10.1111","volume":"25","author":[{"given":"Essam F.","family":"Ebied","sequence":"first","affiliation":[{"name":"Ain Shams University Hospitals Ain\u2010Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9351-0664","authenticated-orcid":false,"given":"Ahmed","family":"Gendia","sequence":"additional","affiliation":[{"name":"Ain Shams University Hospitals Ain\u2010Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem Ahmed","family":"Kamel","sequence":"additional","affiliation":[{"name":"Ain Shams University Hospitals Ain\u2010Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim Magid","family":"Abdel\u2010Maksoud","sequence":"additional","affiliation":[{"name":"Ain Shams University Hospitals Ain\u2010Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-015-1323-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-015-1282-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-011-0769-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31822d7ddd"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcol.2018.05.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1985.tb00849.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31827aab72"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0055-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-019-02093-9"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcol.2017.05.003"},{"issue":"4","key":"e_1_2_11_14_1","first-page":"219","article-title":"Fistula\u2010in\u2010ano in a defined population. 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