Liu JF, Wang Y, Peng XS, Li QL. Enhanced surgical management of complex anal fistulas via integrated traditional Chinese medicine: A retrospective cohort study. World J Gastrointest Surg 2025; 17(11): 110143 [DOI: 10.4240/wjgs.v17.i11.110143]
Corresponding Author of This Article
Qing-Long Li, B.S, Department of Anorectal Diseases of Traditional Chinese Medicine, Jiangsu Provincial People’s Hospital Chongqing Hospital (Qijiang District People’s Hospital), No. 54 Tuowan Branch Road, Gunan Town, Qijiang District, Chongqing 401420, China. 19123401518@163.com
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Gastroenterology & Hepatology
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Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Nov 25, 2025
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Publication Name
World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Liu JF, Wang Y, Peng XS, Li QL. Enhanced surgical management of complex anal fistulas via integrated traditional Chinese medicine: A retrospective cohort study. World J Gastrointest Surg 2025; 17(11): 110143 [DOI: 10.4240/wjgs.v17.i11.110143]
World J Gastrointest Surg. Nov 27, 2025; 17(11): 110143 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.110143
Enhanced surgical management of complex anal fistulas via integrated traditional Chinese medicine: A retrospective cohort study
Ji-Feng Liu, Yu Wang, Xue-Song Peng, Qing-Long Li
Ji-Feng Liu, Yu Wang, Department of Anorectal Surgery, Luzhou People’s Hospital, Luzhou 646000, Sichuan Province, China
Xue-Song Peng, Qing-Long Li, Department of Anorectal Diseases of Traditional Chinese Medicine, Jiangsu Provincial People’s Hospital Chongqing Hospital (Qijiang District People’s Hospital), Chongqing 401420, China
Co-corresponding authors: Xue-Song Peng and Qing-Long Li.
Author contributions: Liu JF, Wang Y, and Peng XS contributed to methodology; Liu JF and Wang Y contributed to conceptualization, data curation, formal analysis, writing, and original draft preparation; Peng XS contributed to resources and investigation; Li QL contributed to supervision, validation, funding acquisition, review and editing; Peng XS and Li QL made equal contributions as co-corresponding authors. All authors approved the final version to publish.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Luzhou People’s Hospital, No. LLW202501002.
Informed consent statement: Informed consent was waived by the Ethics Committee of Luzhou People’s Hospital because of the retrospective nature of the study and the use of anonymized clinical data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Long Li, B.S, Department of Anorectal Diseases of Traditional Chinese Medicine, Jiangsu Provincial People’s Hospital Chongqing Hospital (Qijiang District People’s Hospital), No. 54 Tuowan Branch Road, Gunan Town, Qijiang District, Chongqing 401420, China. 19123401518@163.com
Received: June 13, 2025 Revised: July 23, 2025 Accepted: September 19, 2025 Published online: November 27, 2025 Processing time: 164 Days and 19.7 Hours
Abstract
BACKGROUND
Our research aimed to enhance treatment approaches for difficult anal fistula patients via classical Chinese surgical techniques and assess their healing results by examining past cases.
AIM
To compare the clinical effectiveness and safety of traditional Chinese medicine-integrated surgery with traditional seton-based care for patients with complicated anal fistulas.
METHODS
To assess the safety and therapeutic effectiveness of surgical treatment combined with traditional Chinese medicine with traditional seton-based management for patients with complicated anal fistulas. The standard care group (62 patients) received usual surgical care, including regular seton drainage and fistula cutting procedures. The 70 patients in the enhanced care group underwent specialized Chinese surgical therapy that included the transanal opening of intersphincteric space technique for high muscle-crossing fistulas, personalized set-on techniques, and auxiliary therapies such herbal steam treatments and washing. Our study compared healing success, wound closure time, sphincter function preservation, and after-surgery problems between these groups.
RESULTS
The improved care group achieved 90.0% overall success, which was notably better than the 78.8% overall success rate of the standard care group (P < 0.05). Wounds healed in approximately 21.2 days with improved care compared with 29.5 days with standard care (P < 0.01). Later checkups revealed that the improved group maintained better sphincter control and had fewer complications (6.0% compared with 15.0% in the standard group, P < 0.05).
CONCLUSION
When treating challenging anal fistulas, the improved Chinese surgical technique undoubtedly improves healing results, recovery times, and post-operative complications while preserving improved bowel control.
Core Tip: In 132 patients with complex anal fistulas, this retrospective cohort study compared traditional Chinese medicine-integrated surgical treatment with conventional seton drainage. The integrated approach produced better results. Faster healing (21.5 days vs 28.3 days), less problems (10% vs 20%), decreased recurrence rates (2.9% vs 11.3%), and improved patient satisfaction are some of the main benefits. These results provide a viable therapeutic paradigm for situations where traditional methods prove ineffective, supporting the clinical acceptance of evidence-based traditional Chinese medicine integration in difficult anal fistula therapy.
