3 Committee considerations

3 Committee considerations

The evidence

3.1 To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 7 case series, and is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.

3.2 The specialist advisers and the committee considered the key efficacy outcomes to be: fistula closure, resolution of symptoms, quality of life and recurrence.

3.3 The specialist advisers and the committee considered the key safety outcomes to be: incontinence, abscess, pain, anismus, bleeding and urinary retention.

3.4 One commentary from a patient who had experience of this procedure was received, which was discussed by the committee.

Committee comments

3.5 The committee was informed that it can be difficult to assess whether the fistula is closed without using imaging.

3.6 The committee was informed that this procedure is likely to be less effective in wider fistula tracts.

ISBN: 978-1-4731-3302-0