Recent Advances in the Understanding and Management of Anal Fistula from India

Garg P, Kaur B, Yagnik VD, Dawka S (2021) A new anatomical pathway of spread of pus/sepsis in anal fistulas discovered on MRI and its clinical implications. Clin Exp Gastroenterol 14:397–404. https://doi.org/10.2147/CEG.S335703

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Armstrong DN, Sudoł-Szopińska I, de Parades V, Litta F, Limbert M, Kc J (2023) Pankaj Garg: a community doctor to a master innovator to a global icon. Glob J Med Pharm Biomed Update 18:16–23

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Garg P, Kaur B (2021) The new pathways of the spread of anal fistula and the pivotal role of MRI in discovering them. Abdom Radiol (NY) 46(8):3810–3814. https://doi.org/10.1007/s00261-021-03029-4

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Garg P, Dawka S, Yagnik VD, Kaur B, Menon GR.(2021) Anal fistula at roof of ischiorectal fossa inside levator-ani muscle (RIFIL): a new highly complex anal fistula diagnosed on MRI.Abdom Radiol (NY)46(12): 5550–5563. https://doi.org/10.1007/s00261-021-03261-y

Garg P (2017) Comparison of histopathology and real-time polymerase chain reaction (RT-PCR) for detection of Mycobacterium tuberculosis in fistula-in-ano. Int J Colorectal Dis 32(7):1033–1035. https://doi.org/10.1007/s00384-017-2783-y

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Garg P, Garg M, Das BR, Khadapkar R, Menon GR (2019) Perianal tuberculosis: lessons learned in 57 patients from 743 samples of histopathology and polymerase chain reaction and a systematic review of literature. Dis Colon Rectum 62(11):1390–1400. https://doi.org/10.1097/DCR.0000000000001493

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Garg P, Goyal A, Yagnik VD, Dawka S, Menon GR (2021) Diagnosis of anorectal tuberculosis by polymerase chain reaction, GeneXpert and histopathology in 1336 samples in 776 anal fistula patients. World J Gastrointest Surg 13(4):355–365. https://doi.org/10.4240/wjgs.v13.i4.355

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Garg P, Singh P, Kaur B (2017) Magnetic resonance imaging (MRI): operative findings correlation in 229 fistula-in-ano patients. World J Surg 41(6):1618–1624. https://doi.org/10.1007/s00268-017-3886-x

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Augustine A, Patel PG, Augustine A, John R, Simon B, Eapen A, Mittal R, Chandramohan A (2023) MRI of recurrent fistula-in-ano: is it different from treatment-naive fistula-in-ano and how does it correlate with anal sphincter morphology? Indian J Radiol Imaging 33(1):19–27. https://doi.org/10.1055/s-0042-1758202

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Boruah DK, Hazarika K, Ahmed H, Borah KK, Borah S, Malakar S, Hajoari N (2021) Role of diffusion-weighted imaging in the evaluation of perianal fistulae. Indian J Radiol Imaging 31(1):91–101. https://doi.org/10.1055/s-0041-1729673

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Garg P (2019) Comparison of preoperative and postoperative MRI after fistula-in-ano surgery: lessons learnt from an audit of 1323 MRI at a single centre. World J Surg 43(6):1612–1622. https://doi.org/10.1007/s00268-019-04926-y

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Garg P, Kaur B, Yagnik VD, Dawka S, Menon GR (2021) Guidelines on postoperative magnetic resonance imaging in patients operated for cryptoglandular anal fistula: experience from 2404 scans. World J Gastroenterol 27(33):5460–5473. https://doi.org/10.3748/wjg.v27.i33.5460

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Garg P, Yagnik VD, Kaur B, Menon GR, Dawka S (2021) Role of MRI to confirm healing in complex high cryptoglandular anal fistulas: long-term follow-up of 151 cases. Colorectal Dis 23(9):2447–2455

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Garg P (2017) Comparing existing classifications of fistula-in-ano in 440 operated patients: is it time for a new classification? A retrospective cohort study. Int J Surg 42:34–40. https://doi.org/10.1016/j.ijsu.2017.04.019

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Garg P (2018) Garg classification for anal fistulas: is it better than existing classifications?—a review. Ind J Surg 80(6):606–608. https://doi.org/10.1007/s12262-018-1788-2

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Garg P (2020) Assessing validity of existing fistula-in-ano classifications in a cohort of 848 operated and MRI-assessed anal fistula patients - Cohort study. Ann Med Surg (Lond) 59:122–126. https://doi.org/10.1016/j.amsu.2020.09.022

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Garg P (2020) Classification of anal fistula and abscess. In: Ratto C, Parello A, Litta F, De Simone V, Campennì P (eds) Anal fistula and abscess. Springer International Publishing, Cham, pp 1–23

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Dawka S, Yagnik VD (2021) Comparison between the modified parks and Garg classifications of cryptoglandular anal fistulas. Dis Colon Rectum. https://doi.org/10.1097/DCR.0000000000002208

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Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63(1):1–12. https://doi.org/10.1002/bjs.1800630102

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Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 20(3):623–635. https://doi.org/10.1148/radiographics.20.3.g00mc15623

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Garg P (2018) Is fistulotomy still the gold standard in present era and is it highly underutilized?: an audit of 675 operated cases Int J Surg 56: 26–30 https://doi.org/10.1016/j.ijsu.2018.06.009

Kachare M, Khan A (2023) Role of ultrasonography in evaluation of perianal fistula—a study of 200 cases. J Clin Ultrasound 51(3):536–542. https://doi.org/10.1002/jcu.23396

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Garg P (2019) A new understanding of the principles in the management of complex anal fistula. Med Hypotheses 132:109329. https://doi.org/10.1016/j.mehy.2019.109329

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Garg P (2022) Comparison between recent sphincter-sparing procedures for complex anal fistulas-ligation of intersphincteric tract vs transanal opening of intersphincteric space. World J Gastrointest Surg 14(5):374–382. https://doi.org/10.4240/wjgs.v14.i5.374

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Garg P, Sodhi SS, Garg N (2020) Management of complex cryptoglandular anal fistula: challenges and solutions. Clin Exp Gastroenterol 13:555–567. https://doi.org/10.2147/CEG.S198796

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Garg P, Menon GR, Kaur B (2021) Comparison of different methods to manage supralevator rectal opening in anal fistulas: a retrospective cohort study. Cir Esp (Engl Ed) 16: S0009–0739X(0021)00114–00117 https://doi.org/10.1016/j.ciresp.2021.03.011

Yagnik VD, Kaur B, Dawka S, Sohal A, Menon GR, Garg P (2022) Non-locatable internal opening in anal fistula associated with acute abscess and its definitive management by Garg protocol. Clin Exp Gastroenterol 15:189–198. https://doi.org/10.2147/CEG.S374848

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Garg P, Kaur B, Singla K, Menon GR, Yagnik VD (2021) A simple protocol to effectively manage anal fistulas with no obvious internal opening. Clin Exp Gastroenterol 14:33–44. https://doi.org/10.2147/CEG.S291909

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Garg P, Yagnik VD, Dawka S, Kaur B, Menon GR (2022) A novel MRI and clinical-based scoring system to assess post-surgery healing and to predict long-term healing in cryptoglandular anal fistulas. Clin Exp Gastroenterol 15:27–40. https://doi.org/10.2147/CEG.S343254

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Dawka S, Yagnik VD, Kaur B, Menon GR, Garg P (2022) Garg scoring system to predict long-term healing in cryptoglandular anal fistulas: a prospective validation study. Ann Coloproctol. https://doi.org/10.3393/ac.2022.00346.0049

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Garg P, Sudol-Szopinska I, Kolodziejczak M, Bhattacharya K, Kaur G (2023) New objective scoring system to clinically assess fecal incontinence. World J Gastroenterol 29(29):4593–4603. https://doi.org/10.3748/wjg.v29.i29.4593

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Clemente N, Singhal T, Yagnik V (2023) Garg incontinence scores (GIS): a paradigm shift in assessing fecal incontinence. Glob J Med Pharm Biomed Update 18:19–22. https://doi.org/10.25259/GJMPBU_70_2023

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Garg P, Kaur B (2023) Transanal opening of intersphincteric space: a novel procedure to manage highly complex anal fistulas. Dis Colon Rectum 66(6):e292–e293. https://doi.org/10.1097/DCR.0000000000002612

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Garg P, Kaur B, Menon GR (2021) Transanal opening of the intersphincteric space: a novel sphincter-sparing procedure to treat 325 high complex anal fistulas with long-term follow-up. Colorectal Dis 23(5):1213–1224. https://doi.org/10.1111/codi.15555

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Mishra S, Thakur DS, Somashekar U, Verma A, Sharma D.(2023) The management of complex fistula in ano by transanal opening of the intersphincteric space (TROPIS): short-term results. Ann Coloproctol. https://doi.org/10.3393/ac.2022.01018.0145

Li YB, Chen JH, Wang MD, Fu J, Zhou BC, Li DG, Zeng HQ, Pang LM (2022) Transanal opening of intersphincteric space for fistula-in-ano. Am Surg 88(6):1131–1136. https://doi.org/10.1177/0003134821989048

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Huang B, Wang X, Zhou D, Chen S, Li B, Wang Y, Tai J (2021) Treating highly complex anal fistula with a new method of combined intraoperative endoanal ultrasonography (IOEAUS) and transanal opening of intersphincteric space (TROPIS). Wideochir Inne Tech Maloinwazyjne 16(4):697–703. https://doi.org/10.5114/wiitm.2021.104368

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Garg P (2017) Transanal opening of intersphincteric space (TROPIS) — a new procedure to treat high complex anal fistula. Int J Surg 40:130–134. https://doi.org/10.1016/j.ijsu.2017.02.095

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Garg P (2018) Understanding and treating supralevator fistula-in-ano: MRI analysis of 51 cases and a review of literature. Dis Colon Rectum 61(5):612–621. https://doi.org/10.1097/DCR.0000000000001051

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