FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years

AbstractBackground Surgical treatment of anal fistulas is still a challenge. The aims this study were to evaluate the adoption and healing rates for different surgical techniques used in Italy over past 15 years. Methods This was multicenter retrospective observational patients affected by simple complex cryptoglandular origin who surgically treated period 2003–2017. grouped as sphincter-cutting or sphincter-sparing technology-assisted techno-free. All included followed at least 12 months. Results A total 9,536 (5,520 simple; 4,016 fistulas) entered study. For fistulas, fistulotomy most frequently procedure, although its significantly decreased years (P < .0005), with an increase approaches; overall rate 81.1%, significant difference between (91.9%) (65.1%) = .001). approaches decreased, while mildly preferred .0005). Moreover, there trend toward use procedures. 69.0%, measurable (81.1%) (61.4%; P .001) techno-free (72.5% 55.0%, respectively; Conclusion has changed, techniques. cure remained stable, even if innovative procedures have achieved lower success rate.