Bibliographic record
Abstract
Introduction Complex anal fistulas, unlike simple fistulas, are more difficult to treat because fistulotomy would predictably result in incontinence. The purpose of this study was to compare the use of novel surgical approaches, involving fibrin glue and the anal fistula plug, with that of conventional surgical approaches, involving an extensive fistulomy and flap closure or seton drain insertion, in the management of patients with complex anal fistulas (high to mid-transsphincteric, horseshoe, suprasphincteric, Crohn9s, recurring). In all approaches, care is taken to preserve anal continence. Methods This is a retrospective cohort study of all patients treated for complex anal fistulas by a single colorectal surgeon at the University of British Columbia from 1997 to 2006. The primary outcome was full healing (external fistula opening closed with no drainage or infection) at 3 months postoperatively. Preservation of continence was a secondary outcome. Results There were 45 males and 20 females with a median age of 43 (range 21-75). Fifteen patients were treated by flap closure and fistulotomy external to the sphincter, 33 underwent seton drain insertion and fistulotomy external to the sphincter, 10 were injected with fibrin glue, and 7 had insertion of a fistula plug. Full healing rates were 47% for flap closure, 15% for seton drainage, 30% for fibrin glue, and 57% for plug insertion. Continence was preserved in all patients Conclusions Closure of the primary fistula opening using a biologic anal fistula plug provides an alternate simple method of treating complex anal fistulas. Although only a small number of patients have undergone this new procedure, these are promising preliminary outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".