Reviewer's report
Title:Obesity is a Negative Predictor of Success after Surgery for Complex Anal
Fistula
Version: 1Date:12 March 2011
Reviewer: Wilhelm Graf
Reviewer's report:
Abstract: what does the author mean by “complex” anal fistula. It is better to
define exactly which kind of fistulas that were included.
Introduction: sphincter reconstruction is not an integral part of advancement flap
Methods
Major compulsory revisions
Why do the author choose to use a dichotomous classification of BMI and not a
continous?
Who assessed the patients for healing? If the author did the evaluation
personally there is a risk for bias.
A limitation of the study is the short follow-up, this should be recognized and
discussed.
The statistical methods should be described more in detail.
The author state that:” …. fistulas in which the fistula tract was located in the
upper two-thirds of the external sphincter were treated by rectal advancement
flap repair” What was the technique in the lower third?
Was the study approved by the IRB?
Discretionary revisisons
The word “oralisation” seems eccentric
Results:
Major compulsory revisions
The legend to Table 2 says: Fistula etiology but no such data is presented.
78% had an advancement flap repair, which procedure was used in the
remaining 22%?
A greater proportion in the non obese group were previously unoperated which
can affect the success rate
Which variables were included in the multivariate analysis?
Discussion
Discretionary revisions
The sentence:” Moreover, sufficient of the external wound is mandatory” is
unclear.
The author claim that excision of the entire tract is mandatory – any evidence for
this statement?
Many statements are repeated and the discussion section could be shortened by
removing unnecessary repetitions.
NB Major compulsory revisions are written in bold text. Minor Essential Revisions
are presented in Italic style. Discretionary Revisions are in normal text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:Obesity is a Negative Predictor of Success after Surgery for Complex Anal
Fistula
Version: 1Date:12 March 2011
Reviewer: Wilhelm Graf
Reviewer's report:
Abstract: what does the author mean by “complex” anal fistula. It is better to
define exactly which kind of fistulas that were included.
Introduction: sphincter reconstruction is not an integral part of advancement flap
Methods
Major compulsory revisions
Why do the author choose to use a dichotomous classification of BMI and not a
continous?
Who assessed the patients for healing? If the author did the evaluation
personally there is a risk for bias.
A limitation of the study is the short follow-up, this should be recognized and
discussed.
The statistical methods should be described more in detail.
The author state that:” …. fistulas in which the fistula tract was located in the
upper two-thirds of the external sphincter were treated by rectal advancement
flap repair” What was the technique in the lower third?
Was the study approved by the IRB?
Discretionary revisisons
The word “oralisation” seems eccentric
Results:
Major compulsory revisions
The legend to Table 2 says: Fistula etiology but no such data is presented.
78% had an advancement flap repair, which procedure was used in the
remaining 22%?
A greater proportion in the non obese group were previously unoperated which
can affect the success rate
Which variables were included in the multivariate analysis?
Discussion
Discretionary revisions
The sentence:” Moreover, sufficient of the external wound is mandatory” is
unclear.
The author claim that excision of the entire tract is mandatory – any evidence for
this statement?
Many statements are repeated and the discussion section could be shortened by
removing unnecessary repetitions.
NB Major compulsory revisions are written in bold text. Minor Essential Revisions
are presented in Italic style. Discretionary Revisions are in normal text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:Obesity is a Negative Predictor of Success after Surgery for Complex Anal
Fistula
Version: 1Date:12 March 2011
Reviewer: Wilhelm Graf
Reviewer's report:
Abstract: what does the author mean by “complex” anal fistula. It is better to
define exactly which kind of fistulas that were included.
Introduction: sphincter reconstruction is not an integral part of advancement flap
Methods
Major compulsory revisions
Why do the author choose to use a dichotomous classification of BMI and not a
continous?
Who assessed the patients for healing? If the author did the evaluation
personally there is a risk for bias.
A limitation of the study is the short follow-up, this should be recognized and
discussed.
The statistical methods should be described more in detail.
The author state that:” …. fistulas in which the fistula tract was located in the
upper two-thirds of the external sphincter were treated by rectal advancement
flap repair” What was the technique in the lower third?
Was the study approved by the IRB?
Discretionary revisisons
The word “oralisation” seems eccentric
Results:
Major compulsory revisions
The legend to Table 2 says: Fistula etiology but no such data is presented.
78% had an advancement flap repair, which procedure was used in the
remaining 22%?
A greater proportion in the non obese group were previously unoperated which
can affect the success rate
Which variables were included in the multivariate analysis?
Discussion
Discretionary revisions
The sentence:” Moreover, sufficient of the external wound is mandatory” is
unclear.
The author claim that excision of the entire tract is mandatory – any evidence for
this statement?
Many statements are repeated and the discussion section could be shortened by
removing unnecessary repetitions.
NB Major compulsory revisions are written in bold text. Minor Essential Revisions
are presented in Italic style. Discretionary Revisions are in normal text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
assistant