Study and risk factors analysis of modified transsphincteric anal fistula ligation for intersphincteric anal fistula and transsphincteric anal fistula
WU Chuang,XU Jin,WANG Qing-ming
Department of Anorectal, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine Shanghai201999, China
Abstract:
Objectives To observe the effect of Modified Ligation of the Inter-sphincteric Fistula Tract (MLIFT) on Inter-sphincteric Anal Fistula (ISAF) and Trans-sphincteric Anal Fistula TSAF. Methods A total of 190 ISAF and TSAF patients were randomly divided into treatment group (MLIFT) and control group (fistulectomy). The Visual Analogue Scale (VAS), wound bleeding, distension, urinary retention and Fecal Incontinence Severity Index (FISI) were compared between the two groups on the 1st, 3rd, 7th, 14th, 21st and 30th days after operation. The cure rate and recurrence rate of the two groups were compared. Results The cure rates of the treatment group and the control group were 87.37% and 94.75% respectively, without statistical difference (P>0.05). The recurrence rates of the treatment group and the control group were 7.37% and 2.11%, respectively, with no statistical difference (P>0.05). However, The VAS score on the 1st, 3rd, 7th, 14th day after operation and wound bleeding score on the 1st, 3rd, 7th day after surgery in the treatment group were significantly lower than the control group(P<0.01). On the 1st and 7th postoperative day of the anal distension discomfort and the 1st day after surgery urinary retention in the treatment group were significantly less than the control group (P<0.05). On the 14th day after operation, the discomfort of anal distension in the treatment group was significantly less than that in the control group (P<0.05). The anal maximal contraction pressure and anal squeez pressure of the treatment group were significantly higher than the control group at one year after operation(P<0.05). Conclusion MLIFT can effectively treatment of ISAF and TSAF, and has certain advantages in improving postoperative symptoms and complications without damaging anal sphincter.
