Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 4 Date: 23 Jan 2025
Reviewer's report:
The authors have made changes in the manuscript as I can see. However, I still need to have
some points clarified in this manuscript.
1. it is still unclear for me who and how the patients were selected for the treatment type. It is
very important to clarify in details. As I read in the text it is stated that the study is conducted
as retrospective analysis on patients who enrolled and randomized into two groups.
2.It is not clear if there were patients fistulas after treatment. The internal opening were excided
and drain was applied. As we know from the available evidence fistula formation is high aftaer
Seton drainage.
3. the authors have tried revision of the method description of the treatment group, it is some
how still unclear and difficult to understand.
4. the authors stated that antiotics were prescribed according to blood test results, which is
questionable practice.
5. The authors responded to the question about the difference in the number of patients who had
internal opening identified. It is stated that around 72% of the patients enrolled had an internal
opening with no difference between the groups. In the control group only incision drainage was
done. In the treatment group the internal opening was excised and a rubber drain was applied
through the internal opening to the nearest counter drainage. It seems to me as a significant
difference in the method which can clarify the results in term of cure rate as the internal opening
was not managed in the control group. One can not expect a high healing rate in deep anal
abscess where 73% of the cases with identifiable internal opening by merely incision drainage.
The method of comparing the two treatments has a serious breach.
6. Table 1 needs still a revision.
Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 4 Date: 23 Jan 2025
Reviewer's report:
The authors have made changes in the manuscript as I can see. However, I still need to have
some points clarified in this manuscript.
1. it is still unclear for me who and how the patients were selected for the treatment type. It is
very important to clarify in details. As I read in the text it is stated that the study is conducted
as retrospective analysis on patients who enrolled and randomized into two groups.
2.It is not clear if there were patients fistulas after treatment. The internal opening were excided
and drain was applied. As we know from the available evidence fistula formation is high aftaer
Seton drainage.
3. the authors have tried revision of the method description of the treatment group, it is some
how still unclear and difficult to understand.
4. the authors stated that antiotics were prescribed according to blood test results, which is
questionable practice.
5. The authors responded to the question about the difference in the number of patients who had
internal opening identified. It is stated that around 72% of the patients enrolled had an internal
opening with no difference between the groups. In the control group only incision drainage was
done. In the treatment group the internal opening was excised and a rubber drain was applied
through the internal opening to the nearest counter drainage. It seems to me as a significant
difference in the method which can clarify the results in term of cure rate as the internal opening
was not managed in the control group. One can not expect a high healing rate in deep anal
abscess where 73% of the cases with identifiable internal opening by merely incision drainage.
The method of comparing the two treatments has a serious breach.
6. Table 1 needs still a revision.
Please review this paper.
user
Title: Clinical application of the Intersphincteric Approach with Internal incision combined with
Counter- Drainage for Deep Perianal Abscess
Version: 4 Date: 23 Jan 2025
Reviewer's report:
The authors have made changes in the manuscript as I can see. However, I still need to have
some points clarified in this manuscript.
1. it is still unclear for me who and how the patients were selected for the treatment type. It is
very important to clarify in details. As I read in the text it is stated that the study is conducted
as retrospective analysis on patients who enrolled and randomized into two groups.
2.It is not clear if there were patients fistulas after treatment. The internal opening were excided
and drain was applied. As we know from the available evidence fistula formation is high aftaer
Seton drainage.
3. the authors have tried revision of the method description of the treatment group, it is some
how still unclear and difficult to understand.
4. the authors stated that antiotics were prescribed according to blood test results, which is
questionable practice.
5. The authors responded to the question about the difference in the number of patients who had
internal opening identified. It is stated that around 72% of the patients enrolled had an internal
opening with no difference between the groups. In the control group only incision drainage was
done. In the treatment group the internal opening was excised and a rubber drain was applied
through the internal opening to the nearest counter drainage. It seems to me as a significant
difference in the method which can clarify the results in term of cure rate as the internal opening
was not managed in the control group. One can not expect a high healing rate in deep anal
abscess where 73% of the cases with identifiable internal opening by merely incision drainage.
The method of comparing the two treatments has a serious breach.
6. Table 1 needs still a revision.
assistant