{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:18:02Z","timestamp":1788578282782,"version":"build-2803163510"},"reference-count":27,"publisher":"Korean Society of Coloproctology","issue":"2","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["coloproctol.org"],"crossmark-restriction":true},"short-container-title":["Ann Coloproctol"],"published-print":{"date-parts":[[2022,4,30]]},"abstract":"<jats:p>Purpose: This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand.Methods: A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain.Results: This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median follow-up of 23 months (interquartile range, 12\u201345 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)\u2014accounting for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82\u201312.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P=0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence.Conclusion: Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status.<\/jats:p>","DOI":"10.3393\/ac.2021.01.06","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:35:53Z","timestamp":1623112553000},"page":"133-140","update-policy":"https:\/\/doi.org\/10.3393\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand"],"prefix":"10.3393","volume":"38","author":[{"given":"Weeraput","family":"Chadbunchachai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2252-9509","authenticated-orcid":true,"given":"Varut","family":"Lohsiriwat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisada","family":"Paonariang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1975","reference":[{"key":"ref1","first-page":"278","volume-title":"Ambulatory anorectal surgery under perianal anesthetics infiltration: analysis of 222 cases","author":"Lohsiriwat","year":"2007"},{"key":"ref2","first-page":"103","volume-title":"Towards \u2018zero\u2019 pain for common anal operations by effective anesthetic approach and non-opioid multimodal 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