PAVFCOS: The development of a core outcome set for pouch anal and vaginal fistula.

Aims: The primary aim was to develop a patient-centred core outcome set (COS) for interventional studies in patients with pouch anal and vaginal fistula (PAVF).

Method: PAVFCOS was developed using the methodology outlined by the Core Outcome Measures in Effectiveness Trials (COMET). Systematic review and qualitative patient interviews produced a long list of candidate outcomes.

"Budding"-an early MRI feature established in a case-control study of perianal fistula mucinous adenocarcinoma.

Background: Perianal fistula mucinous adenocarcinoma (FMA) usually presents at an advanced stage, necessitating extensive surgical resection. Symptoms of perianal pain and discharge are indistinguishable from fistula sepsis. Absence of defined features on magnetic resonance imaging (MRI) precludes early diagnosis.

A systematic review of outcome measurement instruments used in pouch anal and vaginal fistulae: a COSMIN-based analysis.

Purpose: Pouch-related fistulae are devastating complications of ileoanal pouch surgery, which is performed to improve the quality of life (QoL) for patients who have had a proctocolectomy. Their management is limited by inconsistent evidence, including using poorly and heterogeneously defined outcomes. This study aims to identify all Outcome Measurement Instruments (OMIs) used in pouch fistula research, including Patient-Reported Outcome Measures (PROMs) and Clinician-Reported Outcome Measures (ClinROMs) and evaluate their quality using COSMIN guidelines to help select the best tool for a standardised core outcome measurement set in a future consensus study.

European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula.

Aim: The primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high-quality, evidence-based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology.

Methods: Previously published methodology in guideline development by the ESCP has been replicated in this project. The guideline development process followed the requirements of the AGREE-S tool kit.

Presentation, management and outcomes of ileoanal pouch cancer: a single-centre experience.

Aim: This study aimed to determine the clinical presentation, management and outcomes for patients with ileoanal pouch cancer.

Method: Patients who were diagnosed with ileoanal pouch cancer were identified from our polyposis registry (1978-2019) and operative and referral records (2006-2019). Details of presentation, endoscopic surveillance, cancer staging and management were retrieved from hospital records.

The pouch behaving badly: management of morbidity after ileal pouch-anal anastomosis.

Aim: Ileal pouch-anal anastomosis (IPAA), or a 'pouch', allows restoration of intestinal continuity after proctocolectomy for ulcerative colitis or familial adenomatous polyposis. Most patients have a good long-term outcome after IPAA, but in a significant proportion the functional outcome and quality of life are unsatisfactory. We term this outcome 'the pouch behaving badly'.

Current review of the management of fistulising perianal Crohn's disease.

Perianal manifestations of Crohn's disease constitute a distinct disease phenotype commonly affecting patients and conferring an increased risk of disability and disease burden. Much research has gone into management of fistulising manifestations, with biological therapy changing the landscape of treatment. In this article, we discuss the up-to-date surgical and medical management of perianal fistulas, highlighting current consensus management guidelines and the evidence behind them, as well as future directions in management.