摘要
目的评价经括约肌间瘘管结扎术(ligation of the intersphincteric fistula tract,LIFT)联合直肠推移瓣术(endorectal advancement flap,ERAF)治疗高位复杂性肛瘘的临床疗效。方法2016年8月~2021年12月我院收治的高位复杂性肛瘘病人40例,根据抽签法随机分成试验组和对照组,每组各20例。试验组采用LITF+ERAF,对照组采用LIFT,随访6~12个月,比较其临床疗效,比较创面愈合时间、治愈率、术后第1天疼痛程度、肛门功能和复发率。结果两组术后第1天疼痛程度、创面愈合时间、治愈率比较差异无统计学意义(P>0.05)。两组术前、创面愈合后、术后6个月的Wexner肛门失禁评分、肛管静息压和肛管最大收缩压比较差异无统计学意义(P>0.05);两组创面愈合后、术后6个月的肛管静息压和肛管最大收缩压分别与其自身术前比较,差异有统计学意义(P<0.05)。随访6~12个月,试验组无复发,对照组复发3例,差异有统计学意义(P<0.05)。结论LITF联合ERAF疗效好、痛苦小、病程短、术后复发率低、肛门功能影响小。
Objective To investigate the clinical value of ligation of the intersphincteric fistula tract(LIFT)combined with endorectal advancement flap(ERAF)in the treatment of high complex anal fistula.Method From August 2016 to December 2021,a total of 40 patients with high complex anal fistula in the anorectal Department were included.They were randomly divided into the experimental group and the control group according to the method of drawing lots,with 20 cases in each group.The experimental group was treated with LIFT+ERAF,and the control group was treated with LIFT.The patients were followed up for 6-12 months to compare the clinical efficacy.Results There was no significant difference in pain degree on the first day after operation,wound healing time and cure rate between the two groups(P>0.05).There was no significant difference in Wexner anal incontinence score,anal resting pressure and anal maximum systolic pressure before operation,after wound healing and 6 months after operation in both groups(P>0.05).The anal resting pressure and the maximum anal systolic pressure after wound healing and 6 months after operation were significantly different from those before operation in both groups(P<0.05).Followed up for 6-12 months,there was no recurrence in the experimental group and there were 3 recurrences in the control group.There was significant difference in the recurrence rate between the two groups(P<0.05).Conclusion LITF combined with ERAF is a new surgical method with good curative effect,less pain,short course of disease,low postoperative recurrence rate and little impact on anal control function.
作者
郭佳
朱传想
何伟
GUO jia;ZHU Chuanxiang;HE Wei(Department of Colorectal Surgery,Clinical Medicine College of Yangzhou University,Jiangsu,Yangzhou 225000,China)
出处
《临床外科杂志》
2023年第1期74-76,共3页
Journal of Clinical Surgery
关键词
经括约肌间瘘管结扎术
直肠推移瓣术
高位复杂性肛瘘
肛门功能
复发
ligation of the intersphincteric fistula tract
endorectal advancement flap
high complex anal fistula
anal function
recurrence
