Association Between Multinucleated Giant Cells and Recurrence of Anal Fistula: A Prospective Cohort Study
- 1Department of General Surgery, Anadolu Healthcare Center in Affiliation with Johns Hopkins Medicine, 41400 Kocaeli, Turkey
- 2Department of General Surgery, Kartal City Hospital, 34100 Istanbul, Turkey
- 3Department of General Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, 17300 Çanakkale, Turkey
Abstract
Background: Recurrence of anal fistulas represents one of the most frequently encountered complications in fistula management and remains a dilemma. Studies investigating the histological structure of fistulas and their relationship with recurrence are extremely limited. Objective: To evaluate the specimens of anal fistulas for the presence of multinucleated giant cells and to assess whether any correlation existed between giant cell presence and fistula recurrence. Design: Prospective cohort study. Patients: Adult patients with intersphincteric perianal fistulas included. Patients with recurrent fistulas, Crohn’s disease, tuberculosis, malignancy, immunocompromised status, pregnancy, or those who declined surgical intervention were excluded. A total of 62 patients were included in the final analysis. Interventions: Fistulotomy and open biopsy taken from the fistula tract. Main Outcome Measures: Postoperative recurrence rates, presence of multinucleated giant cells in the sampled fistula tracts, and the association between giant cell presence and fistula recurrence. Results: After 6 months of follow-up, healing was achieved in 52 patients (84%), while fistula persistence was observed in 10 patients (16%) and considered as recurrence. Giant cells were significantly higher in the recurrence group, whereas age, gender, ASA score, and comorbidity did not differ significantly between recurrence and non-recurrence groups. Giant cell presence was observed in 3 patients (5.8%) without recurrence compared to 4 patients (40.0%) with recurrence (p = 0.01). Other histological markers showed no significant difference between the groups. Conclusions: Our study demonstrates that giant cell presence represents a significant predictor of recurrence in primary cryptoglandular intersphincteric anal fistula.
Related
- Metabolic abnormalities and recurrence in high-risk urinary stone formers: A prospective cohort study.
- Childhood educational, social and health factors associated with the timing and recurrence of NEET status into adulthood: a prospective birth cohort study
- Association of neoadjuvant therapy with locoregional recurrence according to recurrence definitions in breast cancer: a retrospective cohort study
- Association of triglyceride-glucose and its related indices with circadian syndrome : Evidence from a prospective cohort study
- Association of sleep time with all-cause and cardiovascular mortality among individuals with advanced cardiovascular-kidney-metabolic syndrome : A NHANES-based prospective cohort study
BibTeX
@article{inanc2026association,
title = {{Association Between Multinucleated Giant Cells and Recurrence of Anal Fistula: A Prospective Cohort Study}},
author = {Ömer Faruk İnanç and Şermin Çoban Kökten and Kenan Çetin and İsmail Ertuğrul and Wafi Attaallah and Yunus Emre Altuntaş},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218518},
url = {https://www.mdpi.com/2077-0383/15/21/8518},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association Between Multinucleated Giant Cells and Recurrence of Anal Fistula: A Prospective Cohort Study
AU - Ömer Faruk İnanç
AU - Şermin Çoban Kökten
AU - Kenan Çetin
AU - İsmail Ertuğrul
AU - Wafi Attaallah
AU - Yunus Emre Altuntaş
PY - 2026
DA - 2026/11/02
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218518
UR - https://www.mdpi.com/2077-0383/15/21/8518
AB - Background: Recurrence of anal fistulas represents one of the most frequently encountered complications in fistula management and remains a dilemma. Studies investigating the histological structure of fistulas and their relationship with recurrence are extremely limited. Objective: To evaluate the specimens of anal fistulas for the presence of multinucleated giant cells and to assess whether any correlation existed between giant cell presence and fistula recurrence. Design: Prospective cohort study. Patients: Adult patients with intersphincteric perianal fistulas included. Patients with recurrent fistulas, Crohn’s disease, tuberculosis, malignancy, immunocompromised status, pregnancy, or those who declined surgical intervention were excluded. A total of 62 patients were included in the final analysis. Interventions: Fistulotomy and open biopsy taken from the fistula tract. Main Outcome Measures: Postoperative recurrence rates, presence of multinucleated giant cells in the sampled fistula tracts, and the association between giant cell presence and fistula recurrence. Results: After 6 months of follow-up, healing was achieved in 52 patients (84%), while fistula persistence was observed in 10 patients (16%) and considered as recurrence. Giant cells were significantly higher in the recurrence group, whereas age, gender, ASA score, and comorbidity did not differ significantly between recurrence and non-recurrence groups. Giant cell presence was observed in 3 patients (5.8%) without recurrence compared to 4 patients (40.0%) with recurrence (p = 0.01). Other histological markers showed no significant difference between the groups. Conclusions: Our study demonstrates that giant cell presence represents a significant predictor of recurrence in primary cryptoglandular intersphincteric anal fistula.
SN - 2077-0383
ER -