Impacts of Loose Thread-drawing Combined with Tight Thread-drawing on Anal Function and the Changes of Anorectal Pressure in the Treatment of High Anal Fistula
TAN Jin-zhi,XIAO Wan-qing,ZHAN Ben-long
Abstract:
Objective To compare the effects of elasticity combined with hanging thread and traditional hanging thread therapy on Wexner score and anorectal dynamics of postoperative anal function in patients with high anal fistula. Methods Sixty patients of high anal fistula were randomized into a control group and a treatment group, which 30 cases in each one. In the control group, the traditional thread-drawing was applied, while in the treatment group, the loose thread-drawing combined with tight thread-drawing was used. The total clinical therapeutic effects, Wexner score and the changes of anorectal dynamic indicators which included AMCP (Anal Maximal Contraction Pressure, AMCP), ARP (Anal Rest Pressure, ARP) and RRP (Rectal Rest Pressure, RRP) were compared between the two groups. Results The overall effective rate of the postoperative treatment group was 80%, and the control group was 77%, which the difference was not statistically significant (P>0.05). Postoperative treatment group Wexner score (1.10±3.16) was significantly lower than that of the control group (2.97±4.60) (P<0.05). Anorectal motility index: compared with before treatment, there was no significant difference in AMCP values between the two groups after treatment (P>0.05). The RRP [(1.29±0.31) kPa], ARP [( 15 . 82 ±2 . 55 ) kPa] values of the treatment group were lower than those of the RRP [(1.31 ±0 . 19 ) kPa], ARP [( 16 . 45±1 . 81 ) kPa] before treatment, which the difference was not statistically significant (P > 0 . 05 ). The RRP [(0.92 ±0 . 22 ) kPa], ARP [( 12 . 03±1 . 81 ) kPa] of the control group were significantly lower than those of the RRP [(1.34±0.31) kPa], ARP [(17.04±1.12) kPa] values before treatment (P<0.05). The RRP and ARP values of the treatment group after treatment were significantly lower than those of the control group (P<0.05). Conclusion Compared with traditional thread-hanging therapy, elasticity combined with thread-hanging can protect the postoperative anal functional structure and function of patients with high anal ?stula better, thereby
