Systematic review of evidence and consensus on perianal fistula: an analysis of national and international guidelines

Abstract

Evidence on the diagnosis and treatment of perianal fistulae (cryptoglandular or related to CD) ranged from nonexistent to strong, regardless of consensus. The most relevant research questions were identified and proposed as topics for future research.

Can Alpha-1 Antitrypsin be Involved in the Carcinogenesis of Colorectal Cancer?

“…Really in the present analysis the level of evidence found on this relationship is very weak, with only a study providing a 3a level of evidence [16] and all other 3b and 4 levels [15,17,20,21], according to the 2009 Oxford CEBM guidelines [19].…”

“…Evidencebased recommendations of The Oxford Centre for Evidence-Based Medicine (CEBM) guidelines were applied to assess the study quality of evidence and to grade the retrieved articles ( Table 2). The highest level of evidence was scored as sufficient (level 3a or higher of the Oxford CEBM Levels of Evidence 2009) or insufficient [19].…”

S3 guidelines: cryptoglandular anal fistulas

“…Diese Leitlinie stellt eine komplett überarbeitete Neufassung der S3-Leitlinie "Kryptoglanduläre Analfisteln" aus dem Jahr 2011 [290] dar. Primäre Berücksichtigung fanden die Leitlinien anderer Fachgesellschaften (American Society of Colon and Rectal Surgeons [480], Association of Coloproctology of Great Britain and Ireland [483], Italienische Gesellschaft für Kolorektale Chirurgie (SICCR; [21]), Europäische Gesellschaft für Coloproktologie [91] sowie eine Cochrane-Analyse [195]. Im Kapitel Reviews werden diese Aussagen noch einmal gesondert gewertet.…”

Management of complex perianal Crohn’s disease

“…However there are discrepancies in their indications, and it is unclear whether they really represent a complete therapeutic alternative in the treatment of complex fistulas [30]. In our view, they should never be used alone.…”