🔢 Codes · Family 07 of 14
Registry codes: COL-ANA · converted from the registry dossier families/07-anal-complex.md — the dossier remains the source of truth; this page is its reading surface.
27 cards · 🟢 6 verified · 🟡 13 qualified · 🔴 7 disputed · ⚪ 1 qualitative — global registry: 41 disputed cards carry their dispute on the card.
Evidence-based numbers · Continuously updated · Fully referenced · Real live links
27 of 27 cards, in registry-code order
COL-ANA-ABS-PREV-01 · Abscess incidence
20.2 per 100,000 population/year
First anorectal abscess incidence
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-ABS-PROG-01 · Abscess → fistula
15.5% coded / 29.8% prospective; 67.5% within yr 1
Idiopathic first abscess
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-ABS-RISK-01 · Fistula after abscess, by underlying disease
41.6% (4,337/10,427) · 47.2% · 26.7% · 3.51 · 1.85 · 2.9%
IBD overall — Crohn's , ulcerative colitis ; idiopathic 15.5% (see dispute C8-i). Adjusted HRs for fistula: Crohn's (3.38–3.65), UC 1.82, female sex 1.18, age 41–60 (vs <20), intersphincteric site 1.53, ischiorectal site 1.48. Also: of «idiopathic» cases were later diagnosed with Crohn's (median 14 months)
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-ABS-SUCC-01 · Primary fistula surgery (fistulotomy/fistulectomy) at the time of abscess drainage vs drainage alone
RR 0.13 (0.07–0.24) · not significant
Recurrence / persistence / need for further surgery favouring primary fistula surgery; incontinence at 1 year RR 3.06 (0.70–13.45) — , wide CI, I²=44.4%
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-COMP-01 · Headache on GTN
30%
of GTN users (pooled trial arm data); dose-related; CCBs and Botox have fewer adverse events than GTN
During treatment course
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-COMP-02 · Continence disturbance after LIS
Dispute — table B8. · 9.4% · 14%
Short-term RCT pool ; long-term (≥2 yr) pooled (95% CI 9–20): flatus 9%, soilage/seepage 6%, accidental defaecation 0.91%, liquid stool 0.67%, solid stool 0.83%
See dispute table
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-PREV-01 · Fissure lifetime incidence
~11%
Cumulative lifetime incidence
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-REC-01 · Late recurrence after GTN healing
~50%
of fissures that initially heal on GTN recur late
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-SUCC-01 · Topical GTN 0.2–0.4%
48.9% · 35.5%
healed vs placebo (p<0.0009)
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-SUCC-02 · Medical therapy pooled (network estimates)
58.6% · 62.6%
Non-invasive topicals (GTN/CCB pooled) ; botulinum toxin injection
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FIS-SUCC-03 · Lateral internal sphincterotomy (LIS)
93.1% · ≈91.2%
(Ebinger, LIS-specific network estimate); concordant Cochrane pairwise: surgery non-healing 88/1000 → healing vs medical 467/1000 non-healing (15 studies, n=979)
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FST-COMP-01 · Continence impairment after fistulotomy (simple fistula)
any impairment 12.7% · major incontinence 6.0%
Weighted averages: (study range 0–45.7%), gas 3.7%, liquid stool 1.1%, — ascertainment dispute table C8-iii
Pooled across 66-study review's sphincter-cutting arms
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FST-POST-01 · Fistulotomy wound course
41 days
Mean wound healing time ; mean operating time 21 minutes (simple fistula series within Litta)
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FST-SUCC-01 · Fistulotomy for simple fistula
93.7% · 14.7 months
Weighted healing (study range 61–100%), n=4,883, weighted mean follow-up — time-dispute table C8-ii
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FST-SUCC-02 · Sphincter-sparing procedures for simple fistula (pooled within the same review)
77.7%
Success (range 25–100%), n=602, mean FU 13.2 months; continence impairment ~0.2%
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-FST-SUCC-03 · Sphincter-sparing for complex/transsphincteric fistula (modern NMA)
LIFT 71.4% · 74.1% · FiLaC 56.1%
Healing = 100 − failure: , endorectal advancement flap , VAAFT 77.7% (failure 22.3%), (failure 43.9%). Continence worsening: LIFT 1.5%, flap 7.3%, VAAFT 0%, FiLaC 0%. Minor complications: LIFT 4.3%, VAAFT 7.2%, FiLaC 10.2%, flap 6.2%. Crohn's fistulas fail more (39.5% vs 31.4%)
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-01 · Serious complications after RBL
~1 in 100
(2/187 randomised: 1 pain admission, 1 bleeding); older pooled narrative: RBL complications <2% overall
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-02 · Secondary haemorrhage needing hospital care
1.4% (5/352) · 2.1% (7/338) · 0.6% (1/176)
Excisional any-bleeding SAE (bleeding alone 1; +pain 1; +constipation 2; +both 1); stapled ; RBL ; HAL ~1% (2/185, none transfused); transfusion needed in 2 of 690 eTHoS patients
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-03 · Urinary retention needing a catheter
2.0% (7/352)
Excisional ; stapled 1.2% (4/338) — catheterisation SAEs
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-04 · Postoperative pain
2.8% (10/352)
Admission for pain: excisional , stapled 1.8% (6/338). Pain scores (VAS 0–10): day 1 — RBL 3.4 vs HAL 4.6; day 7 — RBL 1.6 vs HAL 3.1; no difference by day 21
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-05 · Anal stenosis
≤1%
: eTHoS SAE stenosis — stapled 2/338 (0.6%), excisional 0/352; older pooled narrative ~1%
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-COMP-06 · Incontinence after excisional haemorrhoidectomy
0.4%
in older pooled series; eTHoS continence scores *improved* after excisional surgery (mean CIS fell, p<0.0001)
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-PREV-01 · Haemorrhoid prevalence (point)
25.9%
Pooled point prevalence (95% CI 22.6–29.2); 1-year prevalence 21.7%; lifetime 27.2%; women 27.3%; examination-based methods 28.1%
🟢 Verified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-RISK-01 · Chronic constipation/straining, low-fibre diet, prolonged sitting, pregnancy, obesity, ageing
Qualitative. · not · not used
In Riss 2012's multivariate analysis BMI was significantly associated with haemorrhoids (p≈0.03–0.04); no defensible pooled rate per factor was found in the sources opened. A «+3.5% risk per BMI point» figure circulating in secondary summaries could be verified against the primary paper and is (see integration block).
⚪ Qualitative · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-SUCC-01 · Rubber band ligation (RBL), grade II–III
single · 49.4% (87/176) · course · 37.5%
Recurrence after a banding session vs HAL 29.8% (48/161); adjusted OR 2.23 (1.42–3.51), p=0.0005. Recurrence after a of RBL (repeat banding allowed): vs 30.0%, aOR 1.35, p=0.20 (NS). 18% needed a second banding; further procedure 32% vs 14%
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-SUCC-02 · Haemorrhoidal artery ligation (HAL)
29.8% (48/161)
Recurrence at 1 year; serious adverse events 12/185 (6.5%): pain 5, bleeding 2, urinary retention 2, vasovagal 2, possible sepsis 1
🟡 Qualified · Registry audit 2026-11-06 · Pending triple review
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COL-ANA-HEM-SUCC-03 · Excisional haemorrhoidectomy (TES) vs stapled haemorrhoidopexy (SH)
Patient-reported recurrence: · 14.0% (39/278) · 25.3% (76/300) · Trial-examined recurrence (Cochrane): · 1.9% (9/476) · 7.7% (37/479)
12 mo — TES vs SH 31.9% (94/295); 24 mo — TES vs SH 42.3% (134/317), OR 2.25 (1.46–3.46). Further surgery by 24 mo: TES 6.2% vs SH 9.3% (p=0.11, NS). conventional vs stapled , OR 3.22 (1.59–6.51)
🔴 Disputed · Registry audit 2026-11-06 · Pending triple review
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