括约肌间瘘管结扎术(LIFT)治疗肛瘘的效果评价

Effect Evaluation of Ligation of the Intersphincteric Fistula Tract in the Treatment of Anal Fistula

目的:括约肌间瘘管结扎术(LIFT)治疗肛瘘可保护肛门功能,但其治疗效果存在争议。本文对采用括约肌间瘘管结扎术(LIFT)治疗肛瘘的文献进行系统综述,探讨其治疗肛瘘的有效性及安全性。方法:检索Pubmed,Ovid SP,Web of Science数据库,检索时间从建库至2014年7月,纳入文献为采用括约肌间瘘管结扎术(LIFT)治疗肛瘘的病例报道。结局指标包括随访时间、手术成功率、并发症、手术时间、伤口愈合时间。结果:最终纳入24篇文献,病例数8~93例,共787例患者。术后随访时间1周~44个月,平均随访时间2~26个月。手术成功率40%~95%,平均71.2%(560/787)。术后并发症发生率2.7%,无严重并发症。手术时间7.5~100 min,平均手术时间11~67.5 min。伤口愈合时间1~36周,平均伤口愈合时间18 d^8周。结论:括约肌间瘘管结扎术(LIFT)是治疗肛瘘的有效方法,是安全的手术方式。

Objective：To explore the efficacy and safety about the treatment of anal fistula,the aim of this article was to review the published literature on the LIFT procedure.Ligation of the intersphincteric fistula tract（LIFT） is a sphincter-preserving procedure in the treatment of anal fistula,while there is debate on the curative effect.Method：Pubmed,Ovid SP and Web of Science database were searched from establishment to July 2014.All studies that investigated the LIFT procedure in the treatment of anal fistula were eligible for inclusion. The primary outcomes measured were the length of follow-up,success rate,complication,duration of the operation and wound healing.Result：Twenty-four articles were finally included for analysis.Sample sizes ranged from 8 to 93 patients,with a total of 787 patients.Followup ranged from 1 week to 44 months, with a reported mean of 2 to 26 months. Success rates ranged from 40% to 95%, with a pooled success of 71.2%（560/787）.No serious complication was reported,with overall complication rate of 2.7%.Duration of the operation ranged from 7.5 to 100 minutes,with a reported mean of 11 to 67.5 minutes.Duration of wound healing ranged from 1 to 36 weeks,with a reported mean of 18 days to 8 weeks. Conclusion：Ligation of the intersphincteric fistula tract is effective in the treatment of anal fistula and is a safe procedure.