2018ACPGBI立场声明_肛瘘的治疗.pdf

Position Statement doi:10.1111/codi.14054 The treatment of anal fistula: second ACPGBI Position Statement – 2018 G. Williams*, A. Williams†, P. Tozer‡, R. Phillips‡, A. Ahmad§, D. Jayne¶ and C. Maxwell-Armstrong** *Royal Wolverhampton NHS Trust, Wolverhampton, UK, †Guy’s and St Thomas’ NHS Foundation Trust, London, UK, ‡St Mark’s Hospital, Harrow, London, UK, §Leeds Teaching Hospitals NHS Trust, Leeds, UK, ¶University of Leeds, Leeds, UK, and **National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK Received 3 December 2017; accepted 16 February 2018 Abstract It is over 10 years since the first ACPGBI Position fistula that have been developed since the original publi- Statement on the management of anal fistula was pub- cation. lished in 2007. This second edition is the result of scru- Keywords Anal sepsis, anal fistula, aetiology, investiga- tiny of the literature published during this time; it tion, surgical treatment updates the original Position Statement and reviews the published evidence surrounding treatments for anal concentrated on publications after 2005, as the literature Introduction prior to that date was reviewed in the original Position Anal fistula remains a perplexing condition for the col- Statement. Organized searches of the Cochrane Database, orectal surgeon. The first ACPGBI Position Statement on PubM