{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:18:11Z","timestamp":1777292291473,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to evaluate whether implantation of an autologous skin graft in the intersphincteric space, as part of the ASGIIFT procedure, improves the primary healing of complex transsphincteric cryptoglandular anal fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective observational IDEAL stage 2a study was conducted at a tertiary referral centre for minimally invasive colorectal surgery and proctology in Croatia between September 2021 and January 2023, with an 18\u2010month follow\u2010up. Preoperative pelvic MRI was performed in all cases, and 40 adult patients who met the inclusion criteria were included in the study. The primary outcome was the postoperative primary healing rate which was defined clinically. Secondary outcomes included postoperative continence disturbance, postoperative pain, time of healing and other postoperative complications (Wexner score and VAS \u2013 Visual Analogue Scale were used). The ASGIIFT procedure includes all standard steps of the LIFT technique (ligation of the intersphincteric fistula tract), with the addition of a pre\u2010prepared autologous dermal graft placed into the intersphincteric space. The study was approved by the institutional ethics committee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Primary clinical healing was achieved in 35 patients (87.5%) within a median of 4\u2009weeks postoperatively (range 3\u20136\u2009weeks). Five initially unhealed patients showed conversion from transsphincteric to intersphincteric fistula during the follow\u2010up period and were subsequently treated by fistulotomy without complications. No patient experienced worsening continence, and no serious postoperative complications occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ASGIIFT appears to be a safe and feasible technique for treating transsphincteric anal fistulas, showing promising early results in this single\u2010centre IDEAL 2a study. Further prospective comparative studies are warranted to validate these initial findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70407","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T04:36:07Z","timestamp":1771302967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Autologous skin graft intersphincteric implantation in anal fistula treatment (\n                    <scp>ASGIIFT<\/scp>\n                    ) \u2013 A novel surgical technique in the treatment of complex transsphincteric anal fistulas"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-0198","authenticated-orcid":false,"given":"Damir","family":"Karlovi\u0107","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery University Hospital Rijeka  Rijeka Croatia"},{"name":"Center for Digestive and Metabolic Medicine, Faculty of Medicine University of Rijeka  Rijeka Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3128-4830","authenticated-orcid":false,"given":"Dorian","family":"Kr\u0161ul","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital Rijeka  Rijeka Croatia"},{"name":"Center for Digestive and Metabolic Medicine, Faculty of Medicine University of Rijeka  Rijeka Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6909-1631","authenticated-orcid":false,"given":"Dora","family":"Fu\u010dkar \u010cupi\u0107","sequence":"additional","affiliation":[{"name":"Center for Digestive and Metabolic Medicine, Faculty of Medicine University of Rijeka  Rijeka Croatia"},{"name":"Department of Pathology, Faculty of Medicine University of Rijeka  Rijeka Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6465-3180","authenticated-orcid":false,"given":"Marko","family":"Zeli\u0107","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital Rijeka  Rijeka Croatia"},{"name":"Center for Digestive and Metabolic Medicine, Faculty of Medicine University of Rijeka  Rijeka 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