低位复杂性肛瘘和瘘管性脓肿改良术后复发29例临床分析

Postoperative Recurrence of Low Complex Anal Fistula and Fistular Abscess：Analysis of 29 Cases

为了总结低位复杂性肛瘘和瘘管性脓肿术后复发的原因及防治经验，回顾性分析低位复杂性肛瘘和瘘管性脓肿改良术后复发29例的临床资料，并采用全层切开、支管部分缝合方法进行再次手术治疗。结果显示，复发原因有内口遗漏、支管处理不当及患者不良生活习惯等，平均手术时间60min，创口平均愈合时间25d，随访6个月至6年无复发。结果表明，内口处理不当是复发的主要原因。全层切开、支管部分缝合是处理低位复杂性肛瘘及瘘管性脓肿改良术后复发的良好方法。

The objective of this study was to summarize the causes ot recurrence of low complex anal fistula and fistular abscess after the improved operation, as well their prevention ＆ treatment. All the recurred cases underwent the procedure of the wbole layer incision and partial suture of the branches. Retrospective analysis showed that the main causes of recurrence were neglect of management of the branches and the inner orifice,unhealthy living style of the patients. As results of the treatment of these recurred cases, the mean operative time was 60 minutes,the mean wound healing period of.time was 25 days,and there were no recurred cases found in the follow up of 0.5-6 years. It is concluded that the inner orifice malmanagement is the main cause of recurrence, and the surgical procedure of whole-layer incision and partial suture of the branches is an optimal one in the treatment of postoperative recurrence of low complex anal fistula and fistular abscess.