Differential trends in Crohn’s fistula vs non-Crohn’s fistula (predominantly cryptoglandular): A bibliometric analysis over two decades

BACKGROUND Anal fistulas have different etiologic characteristics and clinical management strategies in Crohn's disease vs non-Crohn's disease patients.This study systematically analyzed bibliometric studies related to anal fistula over the past 25 years in these two categories with very different clinical characteristics, aiming to reveal global research trends, collaborative networks, and knowledge gaps.AIM To compare the global research trends, collaborative networks, and knowledge gaps between Crohn's anal fistula and non-Crohn's anal fistula (predominantly cryptoglandular) over the past 25 years via bibliometric analysis.METHODS Publications on Crohn's and non-Crohn's anal fistula (predominantly cryptoglandular) from January 1, 2000 to May 1, 2025 were retrieved from the Web of Science Core Collection.Growth trends were assessed using linear and exponential regression models.Co-authorship, co-citation, and co-4 / 74 occurrence networks were constructed and visualized at the country, institutional, and author levels, with centrality measures calculated to identify key nodes.Burst detection was applied to track the evolution of research hotspots over time.RESULTS Crohn's anal fistula research grew exponentially, driven by biologics and stem cell therapies, whereas non-Crohn's fistula (predominantly cryptoglandular) research followed a linear trajectory focused on surgical innovation.The United States emerged as the central hub in both fields, with Asian countries contributing substantially in volume but showing lower citation impact.Crohn's fistula research formed a tightly integrated global network centered on academic medical centers, while non-Crohn's fistula (predominantly cryptoglandular) research relied on regional specialty centers with a more fragmented structure.Research hotspots evolved toward magnetic resonance imaging-guided assessment and sphincter-preserving strategies. CONCLUSIONThis study reveals divergent research trajectories between the two fistula subtypes, highlighting the need for enhanced international collaboration to 5 / 74 bridge academic impact gaps in high-output regions and for crossdisciplinary application of emerging therapies.