The Gastroenterologist's Role in Management of Perianal Fistula

Evaluation of the Reliability and Quality of YouTube Video Content about Perianal Fistulas

OBJECTIVE

Perianal fistulas of the perianal soft tissues are an important cause of morbidity and a significant portion of colorectal surgery. To our knowledge, there is no study evaluating YouTube videos pertaining perianal fistulas. In this study, we aimed to evaluate YouTube video contents on this topic.

METHODS

Whether the videos contained real images, animations or presentations, video duration, number of views, comments and likes, uploading date, and daily view were recorded. Reliability of the videos was assessed using the Quality Criteria for Consumer Health Information (DISCERN) scale and quality of the videos using the Global Quality Score (GQS).

RESULTS

A total of 100 YouTube videos regarding perianal fistulas were included in the study. Sixty-four (64%) videos were uploaded by healthcare professionals and 36 (36%) videos by nonprofessionals. The mean video length was calculated as 6.70 ± 8.00 minutes for all videos. The mean DISCERN score of all videos was found as 3.92 ± 0.81 and the mean GQS score as 3.97 ± 0.83. According to the DISCERN score, most videos included (94%) were of good quality. There was an excellent agreement between the two surgeons in terms of the DISCERN and GQS scores.

CONCLUSION

Most of the videos included in the study were uploaded by health-care professionals. On the other hand, the majority of the videos contained surgical management of perianal fistulas as it is the definitive treatment. Healthcare related content should be audited and filtered by YouTube with new and effective policies.

Modified Van Assche magnetic resonance imaging-based score for assessing the clinical status of anal fistulas

The modified Van Assche magnetic resonance imaging (MRI)-based score is a feasible system to assess the clinical status of anal fistulas in Crohn disease. In this study, we evaluated this score's association with clinical status in patients with anal fistulas (AFs).We included all patients with AF who underwent contrast-enhanced pelvic MRI and surgery between January 2011 and December 2016. The score was evaluated retrospectively preoperatively and 1, 3, and 6 months postoperatively. Univariate and multivariate analyses of the risk factors for AF recurrence were also performed.We retrospectively analyzed data for 104 patients. Twelve (11.5%) patients developed AF recurrence. We classified patients' preoperative clinical status into three grades: 52 (50.0%) grade A, 31 (29.8%) grade B, and 21 (20.2%) grade C. The preoperative MRI-based score was significantly correlated with patients' preoperative clinical status grade (Pearson correlation: 0.547; P < .001). The 3 preoperative clinical status grades showed significant (F = 23.303, P < .001) tendencies for associations with lower respective MRI-based scores. The incidence of AF recurrence decreased with the MRI-based score to 1-month postoperatively, then gradually increased (F = 60.863, P = .000). Long duration of disease, prior interventions, and high MRI-based score were independent risk factors for AF recurrence.The MRI-based score objectively assessed the clinical status and disease activity of patients with AFs, with a high score being associated with severe clinical status and long recovery time.