Clinical observation of transsphincteric TROPIS modified suture method in treatment of high anal fistula
WANG Yan，HOU Yi，ZHENG Xue-ping
Nanjing University of Traditional Chinese Medicine, Nanjing (210000), China
Abstract:
Objective To study the clinical effect of TROPIS modified suture method in the treatment of high anal fistula. Methods Seventy-two patients with high anal fistula were randomly divided into experimental group (TROPIS modified suture method, n=36) and control group (incision suture method, n=36). The pain index, wound area (postoperative day, postoperative 14 days, postoperative 1 month), anal canal resting pressure (ARP), anal canal maximum systolic pressure (AMCP), Wexner score of fecal incontinence, wound healing time, length of stay, hospitalization cost, postoperative complications and recurrence were compared between the two groups. Results There were no significant differences in hospital stay, cure rate, anal canal resting pressure and anal canal maximum systolic pressure between two groups (P > 0.05). The wound healing time in the treatment group [60 (50,79)]d was shorter than that in the control group [110 (96, 129)]d. The hospitalization cost of the treatment group was (11 134.53±3 394.88) yuan, which was less than that of the control group (14 225.92±6 535.61) yuan. The pain index in the treatment group was [1.0 (0.0, 1.0)], lower than that in the control group [2.0 (1.0, 2.0)]. The wound area of the treatment group was (10.58±5.62)cm2, (6.59±4.24)cm2 and (3.56±3.03)cm2 on the day after surgery, 14 days after surgery and 1 month after surgery respectively, which were all smaller than those in the control group (28.05±5.76)cm2, (21.59±4.49)cm2 and (13.48±3.63)cm2. With the extension of treatment time, the reduction of wound area in the treatment group was larger. The score of fecal incontinence 3 months after operation in the treatment group was [0.0 (0.0,1.0)], which was lower than that in the control group [2.0 (0.0, 2.0)]. The probability of postoperative complications of air leakage and fluid leakage was 2.8%(1/35) less than that of control group 16.7% (6/30) (all P < 0.05). Conclusion Compared with incision and transfixion, TROPIS modified suture method for the treatment of high anal fistula has a higher cure rate, less damage to the anal pericardial function, safety and effectiveness, less complications, economic benefits, and it is worthy of clinical promotion.
