OBJECTIVE: 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. Six phases can be identified in the methodology. Phase one sets the scope of the guideline, which addresses the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula in adult patients presenting to secondary care. The target population for this guideline are healthcare practitioners in secondary care and patients interested in understanding the clinical evidence available for various surgical interventions for anal fistula. Phase two involved formulation of the GDG. The GDG consisted of 21 coloproctologists, three research fellows, a radiologist and a methodologist. Stakeholders were chosen for their clinical and academic involvement in the management of anal fistula as well as being representative of the geographical variation among the ESCP membership. Five patients were recruited from patient groups to review the draft guideline. These patients attended two virtual meetings to discuss the evidence and suggest amendments. In phase three, patient/population, intervention, comparison and outcomes questions were formulated by the GDG. The GDG ratified 250 questions and chose 45 for inclusion in the guideline. In phase four, critical and important outcomes were confirmed for inclusion. Important outcomes were pain and wound healing. Critical outcomes were fistula healing, fistula recurrence and incontinence. These outcomes formed part of the inclusion criteria for the literature search. In phase five, a literature search was performed of MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews by eight teams of the GDG. Data were extracted and submitted for review by the GDG in a draft guideline. The most recent systematic reviews were prioritized for inclusion. Studies published since the most recent systematic review were included in our analysis by conducting a new meta-analysis using Review manager. In phase six, recommendations were formulated, using grading of recommendations, assessment, development, and evaluations, in three virtual meetings of the GDG.
RESULTS: In seven sections covering the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula, there are 42 recommendations.
CONCLUSIONS: This is an up-to-date international guideline on the management of cryptoglandular anal fistula using methodology prescribed by the AGREE enterprise.

BACKGROUND: Anogenital disorders encompass a broad spectrum of conditions with diverse pathogenetic origins, often presenting with nonspecific symptoms and overlapping causative factors, thereby posing diagnostic and therapeutic challenges. Effective management requires interdisciplinary knowledge and the use of medical guidelines. Guidelines can play an important role in translating current knowledge into clinical practice and ensuring consistent care, minimizing complications, and optimizing patient outcomes.
OBJECTIVE: The dermatologically relevant guidelines for anogenital disorders, categorized by etiological groups, are reviewed.
METHODS: A selective literature review was conducted, incorporating data from the guideline repository of the Association of the Scientific Medical Societies in Germany (AWMF).
RESULTS: A broad range of current guidelines pertinent to the management of anogenital disorders with relevance for dermatologists is available. These encompass guidelines for the management of chronic inflammatory dermatoses with (potential) involvement of the anogenital region, such as anal eczema, psoriasis, lichen sclerosus, or lichen ruber, as well as sexually transmitted infections and associated conditions, involving a broad range of pathogens, including gonorrhea, chlamydia, syphilis, or human papillomaviruses (HPV)-associated disorders. In this article, we provide an overview of the available guidelines.
CONCLUSIONS: The present article does not claim to be exhaustive. The validity of the mentioned guidelines and the availability of updates needs to be verified in each case.
UNASSIGNED: HINTERGRUND: Im Anogenitalbereich treten vielfältige Erkrankungen mit sehr unterschiedlichen pathogenetischen Ursachen auf. Teils unspezifische Symptome und überlappende Ursachen erschweren die Diagnose und Behandlung. Die effektive Diagnose und Behandlung erfordern interdisziplinäres Wissen und die Anwendung von medizinischen Leitlinien. Leitlinien spielen eine wichtige Rolle beim Transfer des aktuellen Wissensstands in die klinische Praxis und bei der Gewährleistung einer konsistenten Versorgung, Minimierung von Komplikationen und Optimierung der Ergebnisse für Patient*innen.
UNASSIGNED: Ziel war die Erstellung einer Übersicht über die aktuell vorliegenden dermatologisch relevanten Leitlinien für das Management von ausgewählten Erkrankungen des Anogenitalbereichs.
METHODS: Es erfolgte eine elektive Literaturrecherche unter Einbezug des Leitlinienregisters der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).
UNASSIGNED: Es liegt eine Vielzahl aktueller Leitlinien zur Behandlung anogenitaler Erkrankungen von dermatologischer Relevanz vor. Dies umfasst insbesondere Leitlinien für chronisch entzündliche Dermatosen mit (möglicher) Beteiligung des Anogenitalbereichs, wie etwa das Analekzem, die Psoriasis, den Lichen sclerosus oder Lichen ruber, sowie sexuell übertragbare Infektionen und assoziierte Erkrankungen mit einer großen Bandbreite an Pathogenen, etwa Gonorrhö, Chlamydien, Syphilis oder HPV(humane Papillomaviren)-assoziierte Erkrankungen. Im vorliegenden Beitrag geben wir eine Übersicht über die bestehenden Leitlinien.
UNASSIGNED: Die vorliegende Übersicht erhebt keinen Anspruch auf Vollständigkeit. Die Gültigkeit der genannten Leitlinien oder das Vorliegen von Aktualisierungen ist im Einzelfall zu prüfen.

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The significant increase in the incidence of benign anal diseases is related to the fast-paced life style, the change of dietary structure, the increase of work pressure and social psychological factors. Surgery is one of the most important treatments for benign anal diseases, while perioperative defecation management is closely related to the efficacy of surgery. In current clinical practice, there is no consensus on the management of perioperative defecation for benign anal diseases. Hence a discussion was held by the Professional Committee of Colorectal Diseases of Chinese Society of Integrated Chinese and Western Medicine, concerning the causes of perioperative defecation difficulties in perioperative anal benign diseases, the importance and specific strategy of defecation management. A consensus was consequently formed, aiming to provide a guideline for the clinical practice.
肛门良性疾病发病率的显著上升与人们生活节奏的加快、饮食结构的改变、工作压力的增加以及社会心理因素有关。手术是肛门良性疾病重要的治疗方法之一；围手术期排粪管理则与手术疗效密切相关。目前的临床实践中，针对肛门良性疾病的围手术期排粪管理尚缺乏共识意见。为此，中国中西医结合学会大肠肛门病专业委员会组织针对肛门良性疾病围手术期排粪困难的原因、排粪管理的重要性以及管理策略等方面展开讨论，并形成共识意见，以期为肛门良性疾病围手术期排粪管理的临床实践提供参考。.

Perianal dermatitis (anal eczema, perianal eczema) is one of the most common proctological conditions. It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen-induced disorders. The three main types of anal eczema are irritant-toxic, atopic and allergic contact dermatitis. Adequate and successful treatment requires a comprehensive diagnostic workup to determine disease etiology and includes treatment/elimination of causative factors as well as nonpharmacological interventions (avoidance of aggravating factors). In addition, adjuvant topical anti-inflammatory and/or specific symptomatic treatment may be required. The present guidelines contain recommendations for the diagnostic and therapeutic management of perianal dermatitis. Target users of these guidelines are clinicians in the fields of dermatology and proctology, as well as all other specialties involved in the management of patients with perianal dermatitis, both in hospital and office-based settings.

OBJECTIVE: To develop imaging guidelines for patients with fistula-in-ano and other causes of anal sepsis.
METHODS: An expert group of 13 members of the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) used a modified Delphi process to vote on a series of consensus statements relating to the imaging of patients with potential anal sepsis. Participants first completed a questionnaire to gather practice information and to help frame the statements posed.
RESULTS: In the first round of voting, the expert group scored 51 statements of which 45 (88%) achieved immediate consensus. The remaining 6 statements were redrafted following input from the expert group and consensus achieved for all during a second round of voting, including an additional statement drafted. No statement was rejected due to a lack of consensus. After redrafting to improve clarity, 53 individual statements were presented.
CONCLUSIONS: These expert consensus statements can be used to guide appropriate indication, acquisition, interpretation and reporting of medical imaging for patients with potential fistula-in-ano and other causes of anal sepsis.
CONCLUSIONS: • Medical imaging, notably magnetic resonance imaging, is used widely for the diagnosis and monitoring of fistula-in-ano and other causes of anal and perianal sepsis. • While the indexed medical literature is clear that diagnostic accuracy is potentially excellent, this depends on competent image acquisition and interpretation. • In order to facilitate this, the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) has produced expert consensus guidelines regarding the imaging of fistula-in-ano and related conditions.

Perianal necrotizing fasciitis is a serious soft tissue infectious disease of perianal and perineal regions, where a synergistic action of multiple bacteria (including aerobic bacteria and anaerobic bacteria) results in suppurative necrosis of the skin and soft tissue. The disease progress may rapidly cause systemic sepsis through blood circulation, often with complicating shock and MODS, or death. Any delay in diagnosis and treatment of early acute infections may lead to higher mortality because of lack of standardized treatment. The Clinical Guidelines Committee aims to formulate expert consensus on the treatment of perianal necrotizing fasciitis in terms of etiology and pathology, clinical manifestations, laboratory and imaging study, preoperative preparation, surgical treatment (the application of antibiotics, the timing and key points of debridement, assistant therapy), postoperative wound care, nutritional support, surgical reconstruction and rehabilitation. This consensus is a reference for clinicians based on patient conditions.
肛周坏死性筋膜炎是一种发生于肛周、会阴部的严重软组织感染性疾病，多种细菌协调作用（包括需氧菌和厌氧菌）造成皮肤及软组织化脓性坏死。本病进展迅速，可经血液循环引起全身脓毒血症，常并发休克、多器官功能衰竭（MODS）甚至死亡。对早期感染诊断和治疗的延误，可能导致更高的病死率。由于我国目前缺乏统一规范的诊治流程，故中国医师协会肛肠医师分会临床指南工作委员会组织国内专家，通过借鉴国外最新指南及文献，结合我国的研究成果及临床实践，针对肛周坏死性筋膜炎的病因病理、临床表现、实验室及影像学检查、术前准备、治疗（抗生素的应用、清创的时机及要点、辅助手术）、术后伤口管理、营养支持治疗、外科重建、康复等多方面相关问题，进行了多次讨论，最终于2019年4月形成了专家共识。.

The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn\'s disease. Treatment strategies for acute abscesses, active fistulas (active denovo and still active under treatment), fistulas in remission, and rectovaginal fistulas are suggested. Recommendations have been graded following the international recommendations, and when absent, professional agreement has been established. For each situation, practical algorithms have been drawn.