Ligation of the intersphincteric fistula tract vs conventional surgery for anal fistula in Chinese patients

Figure 1 The selection process of studies for the meta-analysis. CNKI: China National Knowledge Infrastructure; RCT: Randomized controlled trial.

Figure 2 Forest plot. A: Cure rate. Forest plot depicting pooled relative risk (RR) of cure following ligation of the intersphincteric fistula tract (LIFT) vs conventional surgery, with 95% confidence intervals (CIs). Each square represents an individual study estimate, and the diamond indicates the overall pooled effect; B: Recurrence rate. Forest plot depicting the pooled RR for recurrence between LIFT and conventional surgery, with 95%CIs. A lower RR indicates reduced recurrence in the LIFT group; C: Complication rate. Forest plot comparing the complication rates between LIFT and conventional surgery. The pooled RR and 95%CIs demonstrate the safety profile of LIFT; D: Postoperative pain. Forest plot of pooled mean differences in the postoperative pain scores (Visual Analog Scale) between LIFT and conventional surgery, with 95%CIs. Negative values favor LIFT. LIFT: Ligation of the intersphincteric fistula tract; CI: Confidence intervals; RR: Relative risk.

Figure 3 Sensitivity analysis for complication rate. Leave-one-out analysis was conducted by sequentially omitting each of the included studies. The pooled relative risk and 95% confidence intervals remained stable, indicating that no single trial significantly influenced the overall estimate. CI: Confidence interval.

Figure 4 Funnel plots for publication bias assessment. Funnel plots evaluating the potential publication bias across the following eight outcomes: Healing time, postoperative pain, operative time, overall clinical effectiveness, anal function, recurrence rate, complication rate, and cure rate. Symmetrical distributions suggest no significant risk of publication bias.