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

Table 1 Summary of evidence comparing ligation of the intersphincteric fistula tract vs conventional surgery for anal fistula

Outcome	Studies (n)	Q	P value (Q test)	I2 (%)	95%CI of I2 (%)	RR	RR P value	RR 95%CI	MD	MD P value	MD 95%CI
Cure rate	39	102.97	< 0.0001	63.1	48.0-73.8	1.0762	0.0074	1.0198-1.1356
Recurrence rate	23	52.04	0.0003	57.7	32.8-73.4	0.6124	0.0323	0.3909-0.9595
Complication rate	31	13.07	0.9969	0.0	0.0-40.2	0.2536	< 0.0001	0.1994-0.3224
Overall effectiveness	67	128.13	< 0.0001	48.5	31.5-61.3	1.1385	< 0.0001	1.1094-1.1684
VAS	48	23290.42	0	99.8					-1.7216	< 0.0001	-2.1018 to -1.3415
Wound healing time	61	3691.79	0	98.4	98.2-98.6				-8.4489	< 0.0001	-9.7276 to -7.1702
Anal function	33	6307.39	0	99.5	99.5-99.6				-1.3793	< 0.0001	-1.9136 to -0.8451
Operative time	41	8043.29	0	99.5	99.5-99.6				3.7127	0.0914	-0.5975 to 8.0230

VAS: Visual Analog Scale; CI: Confidence interval; RR: Relative risk; MD: Mean difference.

Table 2 Summary of Evidence for ligation of the intersphincteric fistula tract vs conventional surgery-continuous outcomes

Outcome	Number of studies (RCTs)	LIFT group (n)	Conventional group (n)	Effect (95%CI)	Certainty of evidence	Reasons for downgrading
Dichotomous outcomes
Cure rate	39	1379/1762	1273/1764	RR = 1.08 (1.02-1.14)	Moderate	Serious risk of bias, inconsistency
Recurrence rate	23	96/1047	139/1048	RR = 0.61 (0.39-0.96)	Moderate	Serious risk of bias, inconsistency
Complication rate	31	75/1325	295/1326	RR = 0.25 (0.20-0.32)	Low	Serious risk of bias, imprecision
Overall clinical effectiveness	67	2568/2709	2221/2709	RR = 1.14 (1.11-1.17)	Moderate	Serious risk of bias, inconsistency
Continuous outcomes
Postoperative pain (VAS)	48	2086	2134	MD = -1.72 (-2.10 to -1.34)	Moderate	Serious risk of bias, inconsistency
Wound healing time (days)	61	2588	2640	MD = -8.45 (-9.73 to -7.17)	Moderate	Serious risk of bias, inconsistency
Anal function (score)	33	1300	1347	MD = -1.38 (-1.91 to -0.85)	Moderate	Serious risk of bias, inconsistency
Operative time (minutes)	41	1789	1811	MD = 3.71 (-0.60 to 8.02)	Moderate	Serious risk of bias, inconsistency

VAS: Visual Analog Scale; RCT: Randomized controlled trial; LIFT: Ligation of the intersphincteric fistula tract; CI: Confidence interval; RR: Relative risk; MD: Mean difference.