Clinical study on the treatment of parks II anal fistula with sphincter decompression filac
MIN Li，LI Yue，WAN Bo-shun
Abstract:
Objective To observe the clinical efficacy of fistula-tract laser closure decompression between sphincters, fistula-tract laser closure, and anal fistulectomy in the treatment of Parks II anal fistula. Methods A total of 132 Parks II anal fistula patients admitted to the Department of Anorectal at Jiading Traditional Chinese Medicine Hospital in Shanghai from January 2021 to December 2022 were randomly divided into treatment group 1 (fistula-tract laser closure group), treatment group 2 (sphincter decompression fistula-tract laser closure group), and control group (fistula resection group), with 44 patients in each group. The healing time, anorectal manometry (evaluation before treatment, 1 month after operation, and 6 months after operation), postoperative symptom and sign scores (evaluation of pain, fever, exudation, and urinary retention on the operation day, the1st, 3rd, 7th, and 14th day after operation), clinical efficacy, and recurrence rate were recorded in the three groups. Results The wound healing time of the treatment group 2 was the shortest, while the control group had the longest healing time. The difference among the three groups was statistically significant (P<0.001). After treatment, the systolic pressure and resting pressure of the anal canal in the three groups decreased to different degrees compared with before treatment. Compared with the control group, the difference between the treatment group 1 and the treatment group 2 was statistically significant (P<0.01), and the difference between the treatment group 2 and the control group was statistically significant (P<0.01). There were no significant differences in the scores of fever and urinary retention among the three groups at all observation periods (P>0.05). Compared with the control group, there were significant differences in exudation and pain scores between treatment group 1 and treatment group 2 (P<0.01) on operation day, 1st, 3rd and 7th days after operation. There was no statistically significant difference in the total effective rate among the three groups (P>0.05). Six months after surgery, there were no recurrent cases in all three groups. Conclusion Sphincter decompression fistula-tract laser closure is effective surgical method for treating Parks II anal fistula. This method has the advantages of minimal trauma, mild postoperative pain, less exudation, and short healing time, which is worthy of clinical promotion for the protection of sphincter.
