Integrating traditional Chinese medicine in anal fistula surgery: A step forward in holistic patient care.

This letter comments on the retrospective cohort study by Liu et al, which evaluates the integration of traditional Chinese medicine (TCM) with conventional seton-based surgery for complex anal fistulas. The study reports a 90.0% success rate in the TCM-integrated group vs 78.8% in the conventional group, with a mean healing time reduced from 28.3 days to 21.5 days and recurrence rates of 5.0% vs 15.0%. These outcomes highlight the potential of TCM modalities - such as herbal decoctions and fumigation - to complement surgical management by addressing inflammation, pain, and tissue regeneration. While the retrospective design and single-center setting warrant cautious interpretation, this work provides a valuable foundation for future randomized trials and underscores the importance of personalized, integrative approaches in colorectal surgery. Further research should focus on standardizing TCM protocols and elucidating the underlying mechanisms of its efficacy.