{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:31:26Z","timestamp":1789655486163,"version":"4.0.1"},"reference-count":0,"publisher":"Annali Italiani di Chirurgia","issue":"1","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann. Ital. Chir."],"abstract":"<jats:p>AIM: Transanal opening of the intersphincteric space (TROPIS) is a minimally invasive surgical treatment for anal fistula that not only eliminates the source of infection but also protects anal function to the greatest extent. This systematic review and meta-analysis aims to evaluate the efficacy of TROPIS in the treatment of anal fistula. METHODS: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for information on TROPIS surgery for anal fistulas performed between the inception of each database and 1 November 2024. We used the single-arm studies for analysis, with a total of 918 subjects and a follow-up period ranging from 3 months to 36 months. The analysis focused on the cure rate of different types of anal fistula, postoperative bleeding, infection, and adverse reactions. RESULTS: This systematic review included six single-arm studies involving a total of 918 patients with anal fistula who underwent TROPIS surgery, with follow-up durations ranging from 3 to 36 months. Among the included studies, all were classified as high quality (score \u22657). This study demonstrated an 80% success rate for the initial operation (95% confidence interval (CI): 0.77\u20130.83), as well as an 80% success rate specifically for high fistulas (95% CI: 0.77\u20130.83). The success rate for second operations was 73% (95% CI: 0.47\u20130.99). For patients with high fistulas who underwent a second procedure, the success rate was 78% (95% CI: 0.40\u20131.00). The cure rate for anal fistulas accompanied by abscesses was 88%, while the cure rate for anal fistulas without abscesses is the same. For horseshoe fistulas, the cure rate was 87%, whereas it was 88% for non-horseshoe fistulas. The overall cure rate in this study was 88% (95% CI: 0.86\u20130.90). The rate of intraoperative bleeding was 3%, the postoperative infection rate was 5%, and the overall incidence of adverse reactions was 3%. CONCLUSIONS: This study demonstrates that TROPIS holds significant potential in the treatment of anal fistulas, particularly for high fistulas, fistulas with associated abscesses, and horseshoe-shaped fistulas, whilst exhibiting a relatively low incidence of incontinence.<\/jats:p>","DOI":"10.62713\/aic.4148","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T10:05:19Z","timestamp":1767953119000},"source":"Crossref","is-referenced-by-count":2,"title":["Transanal Opening of the Intersphincteric Space to Treat Anal Fistula: A Systematic Review and Meta-Analysis"],"prefix":"10.62713","volume":"97","author":[{"given":"Can","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Peng","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Proctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 200437 Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"48935","published-online":{"date-parts":[[2026,1,10]]},"container-title":["Annali Italiani di Chirurgia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.annaliitalianidichirurgia.it\/journal\/AIC\/97\/1\/10.62713\/aic.4148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T09:05:49Z","timestamp":1768467949000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.annaliitalianidichirurgia.it\/journal\/AIC\/97\/1\/10.62713\/aic.4148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,10]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"alternative-id":["S0003-469X(26)00002-0"],"URL":"https:\/\/doi.org\/10.62713\/aic.4148","relation":{},"ISSN":["0003-469X","2239-253X"],"issn-type":[{"value":"0003-469X","type":"print"},{"value":"2239-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,10]]},"article-number":"4"}}