What do systematic reviews say?

IAS preserving seton vs Conventional seton

IAS preserving seton showed no clear difference in recurrence compared with conventional seton (moderate certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 1.88 [0.15, 22.88]
  1 study · 34 participants
  Moderate

Advancement flap vs Fibrin glue with Flap repair

Advancement flap leads to lower recurrence compared with fibrin glue with Flap repair (high certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 0.29 [0.09, 0.92]
  1 study · 58 participants
  High

Fistulotomy vs Fistulectomy

Fistulotomy showed no clear difference in recurrence compared with fistulectomy (moderate certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 1.36 [0.2, 9.02]
  1 study · 45 participants
  Moderate

Island flap anoplasty vs Conventional fistulotomy / seton

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 20 participants
  High

Ayurvedic seton vs Conventional fistulotomy

Ayurvedic seton showed no clear difference in recurrence compared with conventional fistulotomy (moderate certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 0.38 [0.02, 9.64]
  1 study · 100 participants
  Moderate

Radiofrequency vs Conventional fistula surgery

Radiofrequency showed no clear difference in recurrence compared with conventional fistula surgery (low certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 0.73 [0.15, 3.48]
  2 studies · 122 participants
  Low

Fistulotomy vs Marsupialization fistulotomy

Fistulotomy showed no clear difference in recurrence compared with marsupialization fistulotomy (moderate certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 1.26 [0.27, 5.97]
  2 studies · 137 participants
  Moderate

Fibrin glue vs Conventional fistulotomy / seton

Fibrin glue showed no clear difference in recurrence simple fistula compared with conventional fistulotomy / seton (moderate certainty).

• Surgical intervention for anorectal fistula 2010 · Cochrane Headline outcomes only
  OR 15 [0.6, 376.7]
  1 study · 13 participants
  Moderate

Physical activity vs usual care

The review found no eligible studies for this question.

• Physical activity interventions for disease‐related physical and mental health during and following treatment in… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Surgery vs any Medical Therapy

Any Surgery leads to lower NON ‐ Healing (persistence or recurrence) compared with any Medical Therapy (high certainty).

• Non surgical therapy for anal fissure 2012 · Cochrane Headline outcomes only
  OR 0.11 [0.06, 0.23]
  15 studies · 979 participants
  High

Glyceryl trinitrate (GTN) vs placebo

GTN may leads to lower NON ‐ Healing of fissure (persistence or recurrence) compared with placebo (low certainty).

• Non surgical therapy for anal fissure 2012 · Cochrane Headline outcomes only
  OR 0.35 [0.19, 0.65]
  18 studies · 1315 participants
  Low