LIFT与切开挂线术治疗复杂性肛瘘的疗效比较

Comparison of the curative effects between The ligation of intersphinc-teric fistula tract and incision-thread-drawing procedure for complex anal fistula

目的探讨括约肌间瘘管结扎术(ligation of intersphinc-teric fistula tract,LIFT)与切开挂线术(incision-threaddrawing procedure)治疗复杂性肛瘘的临床疗效。方法对39例经LIFT手术治疗复杂性肛瘘(LIFT组)和44例经切开挂线术治疗复杂性肛瘘(切开挂线组)的患者临床资料进行回顾性分析,观察两组手术时间、术中出血量、临床疗效、术后并发症、复发率等。结果 LIFT组治愈率87.2%,切开挂线组治愈率93.2%,两组比较差异无显著统计学意义(P>0.05),LIFT组术中出血、术后创面大小、术后换药疼痛持续时间、创面愈合时间、住院时间、Wexner肛门失禁评分均优于切开挂线组(P<0.05)。结论 LIFT手术治疗复杂性肛瘘具有手术创伤小、恢复快、痛苦少,复发率低等优点,可以在临床应用。

Objective To study the ligation of intersphinc-teric fistula tract （LIFT） and incision-thread- drawing procedure clinical curative effect for the treatment of complex anal fistula. Methods A retrospec- tive analysis was made on the clinical date of 39 cases of LIFT in the treatment of complex anal fistula, and 44 cases of incision-thread-drawing procedure were applied in the treatment of complex anal fistula. Operation time, intraoperative blood loss, clinical curative effect, the postoperative complications and recurrence rate were observed between the two groups. Results The cure rate was 87.2% in the LIFT group, and 93.2% in the incision-thread-drawing procedure group, which had no significant difference between two gourps （ P 〈0.05）. The intraoperative bleeding, postoperative wound size, treatment duration of pain, wound healing time, postoperative hospital stay and Wexner anal incontinence scores were better in the LIFT group compared with the incision-thread-drawing procedure group （ P 〈 0.05 ）. Conclusion The LIFT has small surgical trauma, rapid recovery, less painful and low recurrence rate in the treatment of complex anal fistula, which could be applied in the clinic.