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World J Gastroenterol. Sep 21, 2026; 32(35): 121507
Published online Sep 21, 2026. doi: 10.3748/wjg.121507
Published online Sep 21, 2026. doi: 10.3748/wjg.121507
Fistulotomy under general anesthesia in infants and toddlers: A retrospective cohort study on perioperative safety and long-term recurrence
Xue-Cheng Zhang, Huang-Fu Ma, Yan-Mei Wang, Xin-Bo Song, Yue Wang, Department of Proctology, China-Japan Friendship Hospital, Beijing 100029, China
Zhang-Yun Zhou, Department of Gastrointestinal Surgery, Anhui Zhongke Gengjiu Hospital, Hefei 230051, Anhui Province, China
Li-Na Zhang, Department of Traditional Chinese Medicine Proctology, Hohhot Traditional Chinese and Mongolian Medicine Hospital, Hohhot 010000, Inner Mongolia Autonomous Region, China
Fang Kong, College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
Co-first authors: Xue-Cheng Zhang and Huang-Fu Ma.
Co-corresponding authors: Xin-Bo Song and Yue Wang.
Author contributions: Zhang XC and Ma HF drafted the manuscript, they contributed equally to this work as co-first authors; Wang Y and Song XB participated in the study design and coordination, they contributed equally to this work as they are co-corresponding authors; Zhang LN and Zhou ZY handled follow-up and data/picture collection; Zhang XC and Wang Y performed data curation; Kong F conducted software and formal analysis; Zhang XC, Ma HF, Zhou ZY, Zhang LN, Kong F, Wang YM, Song XB, Wang Y read and approved the final version.
AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors. AI tools (ChatGPT) were used solely for linguistic refinement and formatting assistance in the “Answering Reviewers”.
Supported by Independent Research Project of China-Japan Friendship Hospital, No. 2024-ZF-31.
Institutional review board statement: The study was approved by the Ethics Committee of China-Japan Friendship Hospital (approval No. 2024-KY-387).
Informed consent statement: The study was approved by the Ethics Committee of China-Japan Friendship Hospital, which waived the requirement for written informed consent. Verbal informed consent was obtained from all participants via telephone prior to enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: All data supporting this study are included within the article and/or its Supplementary material.
Corresponding author: Yue Wang, MD, PhD, Doctor, Department of Proctology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, China. wangyue@zryhyy.com.cn
Received: April 2, 2026
Revised: April 30, 2026
Accepted: May 20, 2026
Published online: September 21, 2026
Processing time: 135 Days and 20 Hours
Revised: April 30, 2026
Accepted: May 20, 2026
Published online: September 21, 2026
Processing time: 135 Days and 20 Hours
Core Tip
Core Tip: Infants and toddlers differ in fistula location patterns and surgical outcomes, likely reflecting the distinct developmental pathological processes that evolve in early childhood. Our study reveals fistulotomy under general anesthesia appears to be a safe and effective option for infants/toddlers with fistula-in-ano, with low recurrence rate and a negligible impact on fecal continence. Given this favorable safety record, the potential risks of general anesthesia should be balanced against the benefits of definitive treatment, and necessary surgical intervention should not be postponed because of anesthesia concerns.