Prognostic Value of Serum Insulin-Like Growth Factor-1 in Patients With Anal Fistula Treated by Incision-Thread-Drawing Surgery.

Background: Anal fistula is a chronic condition characterized by an abnormal tract between the anal canal and perianal skin, often leading to infection, inflammation, and impaired quality of life. Incision-thread-drawing surgery is the main treatment for anal fistula. However, the risk of poor postoperative healing remains significant. This study investigates the prognostic value of preoperative serum insulin-like growth factor-1 (IGF-1) levels in predicting wound healing after incision-thread-drawing surgery for anal fistula. Methods: A total of 129 patients undergoing incision-thread-drawing surgery for anal fistula were enrolled. Patients were divided into a healing group (n = 87) and a non-healing group (n = 42) based on wound healing status at 1 month post-surgery. Serum IGF-1 levels were measured preoperatively, and their association with wound healing, inflammatory cytokines, and postoperative anal function was analyzed using logistic regression, receiver operating characteristic (ROC) analysis, and Wexner Incontinence Score. Results: Preoperative serum IGF-1 levels were significantly lower in the non-healing group (p < 0.001). IGF-1 levels above 174.9 ng/mL were associated with better wound healing (OR = 0.603, p = 0.005) and lower postoperative inflammation. Higher IGF-1 levels correlated with improved anal function at 7 and 14 days post-surgery (p < 0.01). Conclusion: Preoperative serum IGF-1 levels are a valuable prognostic biomarker for predicting wound healing and postoperative recovery in patients undergoing incision-thread-drawing surgery for anal fistula, potentially guiding clinical decision-making and patient management strategies.