ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1579652
This article is part of the Research TopicAdvances in Medical Imaging for Precision Diagnostic and Therapeutic Applications in Digestive DiseasesView all 10 articles
Clinical Evaluation of Day Surgery for Anal Fistula Excision with MRI-Assisted Diagnosis: A Retrospective Analysis of 121 Cases
Provisionally accepted
Shaohua Zhang1
Fangying Chen2Yifan Wei1Xiaolu Ma2Haidi Lu2Youyu Luo1
Liqiang Hao1*
Jianping Lu2*Yonggang Hong1*- 1Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, Beijing Municipality, China
- 2Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
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The clinical practice of anal fistula excision surgeries conducted in the day surgery unit was analyzed, and the efficacy and safety of this surgery were evaluated.: The clinical data of 121 patients with anal fistulas who underwent excision surgery at Changhai Hospital from October 2021 to April 2024 was retrospectively analyzed, including age, gender, body mass index (BMI), diagnosis, fistula characteristics (number and locations of internal and external openings), preoperative magnetic resonance imaging (MRI) of fistulas, surgical and anesthetic methods, length of hospital stay, verbal rating scale (VRS), outpatient follow-up frequency, wound healing status, rehabilitation time, postoperative complications, and patient satisfaction. Kappa statistics were employed to evaluate the value of MRI in assessing the Parks classification and the number of fistulas compared with that of intraoperative findings. Results: All 121 patients successfully underwent anal fistula excision or excision combined with seton placement, with no patients lost to follow-up. All patients fully recovered, achieving a cure rate of 100%. Postoperative complications were rare, with only one patient (0.3%) experiencing pruritus and no recurrence. The rate of patient satisfaction reached 96.7%. The accuracies of the Park classification and number of fistulas assessed by MRI were 95.9% and 94.2%, respectively. The Kappa values were 0.948 and 0.848, respectively.Day surgery for anal fistula excision resulted in shorter hospital stays, lower medical costs, and fewer postoperative complications. Furthermore, MRI provided a reliable preoperative assessment of the Parks classification and the number of fistulas. Such an approach is a safe and feasible surgical treatment that deserves wider adoption.
Keywords: anal fistula, surgical treatment, day surgery, clinical practice, MRI
Received: 19 Feb 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Zhang, Chen, Wei, Ma, Lu, Luo, Hao, Lu and Hong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Liqiang Hao, Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, Beijing Municipality, China
Jianping Lu, Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
Yonggang Hong, Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, Beijing Municipality, China
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