Annals of Coloproctology

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Original Article

Benign proctology

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study: Julie Assaraf, Elsa Lambrescak, Jérémie H Lefèvre, Vincent de Parades, Josée Bourguignon, Isabelle Etienney, Milad Taouk, Patrick Atienza, Jean-David Zeitoun; Ann Coloproctol. 2021;37(2):90-93. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.06.18

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Purpose
Anal fistula is a common condition in proctology, usually requiring surgical treatment. Few risk factors have been clearly identified based on solid evidence. Our research objective was to determine whether history of anal surgery was a risk factor for subsequent anal fistula.
Methods
We conducted a case-control study from January 1, 2012 through December 31, 2013 in our tertiary center, comprising 280 cases that underwent surgery for anal fistula and 123 control patients seeking a consultation for upper gastrointestinal symptoms. Patients with inflammatory bowel disease were excluded. For both cases and controls, the following variables were recorded: sex, any prior anal surgery, diabetes mellitus, infection with human immunodeficiency virus, and smoking status. For each variable, confidence interval and odds ratio (OR) were calculated.
Results
In univariate analysis, male sex (73.2% vs. 31.7%, P < 0.0001), active smoking (38.1% vs. 22%, P = 0.0015), and prior anal surgery (16.0% vs. 4.1%, P = 0.0008) were associated with higher risk of anal fistula. In multivariate analysis, only male sex (OR, 5.5; 95% confidence interval [CI], 5.42 to 9.10; P < 0.0001) and previous anal surgery (OR, 4.48; 95% CI, 1.79 to 13.7; P = 0.0008) remained independently associated with anal fistula occurrence.
Conclusion
The epidemiology of anal fistula is poorly assessed despite the high frequency at which it is diagnosed. Our findings suggest that history of any kind of anal surgery is a risk factor for further onset of anal fistula. Surgeons and patients must be informed of this issue.

Citations

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Tangtang He, Kewei Wang, Ruiwen Mo, Juntong Guo, Bin Jiang, Ruoyu Mu, Wen Min, Lifeng Zhu, Jun Chen
Chinese Medicine.2026;[Epub] CrossRef
Five-year trends in proctological practice in Dubai: Insights from a high-volume referral centre
Salman Muhammad Soomar, Lynn Rachael Aranha, Bibi Erum Jan Muhammad, Mouhsen Al Hosein
BMC Surgery.2026;[Epub] CrossRef
Perianal fistula a silent epidemic that face proctology and coloproctology in public health
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Salud, Ciencia y Tecnología.2025; 5: 1360. CrossRef
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The Ewha Medical Journal.2022;[Epub] CrossRef
Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study
Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney
Annals of Coloproctology.2022; 38(5): 370. CrossRef

Review

Risk Factors of Colorectal Cancer.: Kim, Dong Hyun; J Korean Soc Coloproctol. 2009;25(5):356-362.; DOI: https://doi.org/10.3393/jksc.2009.25.5.356

4,533 View
96 Download
18 Citations

Abstract PDF

Colorectal cancer has been rapidly increasing in Korea during the past decades, which was known as low risk area. The age-standardized mortality rates increased from 3.0 to 14.5 in 100,000 for men and from 2.3 to 7.9 in 100,000 for women between 1983 and 2008. According to the National Cancer Registry, the age-standardized incidence rates of total colorectal cancer were increased by 7.3% and 5.5% for men and women, respectively, between 1999 and 2005, while the incidence rates of the most prevalent cancers in Korea, such as stomach, liver, and cervical cancers, have decreased during the same period. Westernized dietary and lifestyle-related factors seem to be closely related to the increased risk of colorectal cancer. Higher intakes of red and processed meat, a lack of physical activity, obesity, and alcohol drinking have been suggested to be risk factors for colorectal cancer in the numerous epidemiologic studies, while higher intakes of dietary fiber, green leafy vegetables, some micronutrients abundant in vegetables and fruits, such as folate, and calcium were reported to be protective factors. Since many of the diet and lifestyle-related factors for colorectal cancer are modifiable, it is urgently needed to set up comprehensive primary prevention program against colorectal cancer to effectively cope with the rapidly increasing cancer in Korea.

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