Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University , Kunming, China.
Expert Rev Gastroenterol Hepatol. 2020 Dec;14(12):1159-1169. doi: 10.1080/17474124.2020.1811683. Epub 2020 Sep 6.
The occurrence of perineal fistula is a significant evesnt in the evolution of Crohn's disease. Approximately 21% to 23% of patients develop perineal fistula at least once in their lifetime, approximately 30% of patients have cases of recurrence, and the refractory and recurrent perineal lesions of Crohn's disease impose a great economic burden on patients. The main purpose of this review was to investigate the quality of guidelines for perineal fistula in Crohn's disease.
Relevant websites and databases were systematically searched to identify and select clinical guidelines related to perineal fistulas in Crohn's disease. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and used intraclass correlation coefficients (ICC) to measure the agreement among the guideline reviewers.
There is much room for improvement in the quality of guidelines for the management of perineal fistulas in Crohn's disease. The recommendations and evidence for guidelines for the management of perineal fistulas in Crohn's disease are quite heterogeneous, and guideline-developers would be well advised to address the above issues during future guideline development.
肛门瘘的发生是克罗恩病演变过程中的一个重大事件。大约 21%至 23%的患者一生中至少会发生一次肛门瘘，大约 30%的患者会复发，克罗恩病的难治性和复发性肛门病变给患者带来了巨大的经济负担。本综述的主要目的是调查克罗恩病肛门瘘的指南质量。
系统地搜索了相关网站和数据库，以确定并选择与克罗恩病肛门瘘相关的临床指南。四名独立的审查员使用评估指南研究与评估 II（AGREE II）评估合格的指南，并使用组内相关系数（ICC）来衡量指南审查员之间的一致性。
克罗恩病肛门瘘管理指南的质量还有很大的改进空间。克罗恩病肛门瘘管理指南的建议和证据存在很大的异质性，指南制定者在未来的指南制定过程中最好解决上述问题。
