{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:49:51Z","timestamp":1775710191968,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016350","name":"Sichuan Provincial Administration of Traditional Chinese Medicine","doi-asserted-by":"crossref","award":["TJZ2025GHLZYXM"],"award-info":[{"award-number":["TJZ2025GHLZYXM"]}],"id":[{"id":"10.13039\/501100016350","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Noncommunicable Chronic Diseases\u2014National Science and Technology Major Project","award":["2024ZD0527200"],"award-info":[{"award-number":["2024ZD0527200"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether a modified anal fistula plug combined with a drainage seton can improve postoperative pain and 12-month healing rates, and to assess its effects on healing time, recurrence, bowel-function recovery, and other outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center comparative cohort study at West China Hospital, including 140 patients with cryptoglandular anal fistula treated between January 2022 and December 2024. Patients were categorized by whether they received the anal fistula plug group (AFP) or not. Both groups followed our institution-specific postoperative pathway combining Chinese herbal fumigation with a protocolized recovery bundle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline clinical characteristics were comparable between groups. Compared with contrast group, the AFP group showed faster postoperative recovery, with lower early postoperative pain and a shorter median time to healing. Functional recovery and overall clinical effectiveness were also higher early after surgery. At 12\u202fmonths, overall effectiveness was similar between groups and recurrence did not differ significantly. Subgroup analysis suggested a greater acceleration of healing in patients with longer preoperative disease duration (\u224845\u2013365\u202fdays).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The modified AFP with drainage seton facilitates early recovery, significantly reduces postoperative pain, and shortens time to healing without increasing costs or hospital stay. Over 12\u202fmonths, long-term efficacy and safety are comparable to conventional treatment, supporting the plug as a sphincter-preserving, cost-conscious alternative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1767824","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:11:48Z","timestamp":1775707908000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Healing and functional outcomes after treatment of high anal fistula with a modified anal fistula plug: a prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Rui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanlin","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"ref1","volume-title":"Anal Fistula and Abscess. 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A scoping review of the literature","volume":"30","author":"Tan","year":"2025","journal-title":"Eur J Med Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"7838","DOI":"10.1038\/s41598-022-11712-9","article-title":"Cutting seton versus decompression and drainage seton in the treatment of high complex anal fistula: a randomized controlled trial","volume":"12","author":"Yu","year":"2022","journal-title":"Sci Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"265","DOI":"10.5505\/ejm.2023.46578","article-title":"Comparison of loose and cutting seton methods in anal fistula treatment","volume":"28","author":"T\u00fcmer","year":"2023","journal-title":"East J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"832397","DOI":"10.3389\/fsurg.2022.832397","article-title":"Sphincter-preserving Fistulectomy is an effective minimally invasive technique for complex anal fistulas","volume":"9","author":"Hong","year":"2022","journal-title":"Front Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"617","DOI":"10.4066\/biomedicalresearch.29-17-2507","article-title":"Clinical efficacy of anal fistula plug treatment regimens in anal fistula patients","volume":"3","author":"Fang","year":"2018","journal-title":"Allied Acad"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s00423-020-02024-5","article-title":"Effects of an anal fistula plug on anal function after surgery for treatment of a trans-sphincteric anal fistula","volume":"406","author":"Tao","year":"2021","journal-title":"Langenbeck's Arch Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"100026","DOI":"10.1016\/j.hsr.2022.100026","article-title":"Advancing standard techniques for treatment of perianal fistula; when tissue engineering meets seton","volume":"3","author":"Nazari","year":"2022","journal-title":"Health Sci Rev"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1111\/j.1463-1318.2009.01933.x","article-title":"The efficacy of anal fistula plug in fistula-in-ano: a systematic review","volume":"12","author":"Garg","year":"2010","journal-title":"Colorectal Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta23210","article-title":"Anal fistula plug versus surgeon's preference for surgery for trans-sphincteric anal fistula: the FIAT RCT","volume":"23","author":"Jayne","year":"2019","journal-title":"Health Technol Assess"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1007\/s10151-016-1505-8","article-title":"Results of the Gore bio-a fistula plug implantation in the treatment of anal fistula: a multicentre study","volume":"20","author":"Herold","year":"2016","journal-title":"Tech Coloproctol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"6483","DOI":"10.1038\/s41598-020-63541-3","article-title":"Longterm outcome of anal fistula - a retrospective study","volume":"10","author":"Andreou","year":"2020","journal-title":"Sci Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1767824\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:11:51Z","timestamp":1775707911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1767824\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":19,"alternative-id":["10.3389\/fmed.2026.1767824"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1767824","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"article-number":"1767824"}}