Clinical Study of Cutting of Intersphincter Space in the Treatment of High Anal Fistula
GUO Gao-zheng,ZHENG Xue-ping,TAN Yan-yan
Abstract:
Objective To study the clinical effect of cutting of intersphincter space in thetreatment of high anal fistula. Methods According to the method of random number table, 72 patients with high anal fistula were randomly divided into control group(cutting seton) (n=36) and experimental group(cutting of intersphincter space) (n=36).The basic situation ofoperation, clinical effect, anal function, wound area, local pain and complications were compared between the two groups. Results The hospitalization time of the test group was (8.22±2.10) days, which was shorter than that of the control group (14.17±2.83) days. The wound healing time in the test group was (35.75±11.15) days, which was shorter than that in the control group (55.69±13.42) days. Three months after operation, the anal resting pressure and the maximum anal systolic pressure in the test group were (58.39±6.72) mmHg and (143.72±8.24) mmHgrespectively, which were higher than those in the control group (51.25±4.33) mmHg and (126.75±11.49) mmHg. Three months after operation, the Wexner score of fecal incontinence in the experimental group was lower than that in the control group (0.56±0.61), which was lower than that in the control group (3.25±0.81). On the day of operation, 7 days after operation and 14 days after operation, the wound area of the test group was (10.70±1.67) cm2, (8.34±1.18) cm2 and (6.25±1.13) cm2 respectively, which were smaller than those of the control group (20.52±1.58) cm2, (16.26±2.37) cm2 and (13.98±2.24) cm2 respectively. The pain index of the test group was (3.44±0.91), (4.17±0.77) and (2.64 ±0 . 82 ) at 7 hours, the first defecation and the 7th day after operation respectively, which were lower than those of the control group (6.25±0.73), (7.22±1.20) and (5.28±1.49).The incidence of postoperative complications in the test group was 17%, which was lower than that in the control group (53%) (all P<0.05).There was no signi?cant difference in recurrence rate and clinical curative effect between the two groups (all P>0.05). Conclusion Compared with cutting seton, cutting of intersphincter space in the treatment of high anal ?stula has signi?cant advantages such as
