改良经括约肌间瘘管结扎术与切开挂线术治疗复杂性肛瘘的效果及对复发率的影响

Effects of modified ligation of intersphincteric fistula tract and incision and thread-drawing on complex anal fistula and the influence on recurrence rate

目的 探讨改良经括约肌间瘘管结扎术(LIFT)与切开挂线术治疗复杂性肛瘘的效果及对复发率的影响.方法 选取2016年1月至2017年7月本院收治的112例复杂肛瘘患者为研究对象,随机将其分为挂线组和改良组,各56例.挂线组采用切开挂线术治疗,改良组采用改良LIFT术治疗.比较两组的治疗效果、临床相关指标、肛门功能及复发情况.结果 两组的治疗总有效率与复发率均无显著差异(P>0.05).改良组的术中出血量少于挂线组,术中创面面积小于挂线组,疼痛持续时间、住院时间、伤口愈合时间均短于挂线组(P<0.05).术后3个月,改良组Wexner评分低于挂线组(P<0.05).结论 改良LIFT术与切开挂线术治疗复杂性肛瘘效果相当,但改良LIFT术能有效保护肛门功能,促进疾病恢复,且未增加术后的复发率.

Objective To explore the effects of modifie dligation of intersphincteric fistula tract(LIFT) and incision and thread-drawing on complex anal fistula and the influence on recurrence rate. Methods A total of 112 patients with complex anal fistula admitted in the hospital from January 2016 to July 2017 were selected as study objects. The patients were randomly divided into thread-drawing group and modified group, with 56 cases in each group. The thread-drawing group was treated with incision and thread-drawing, and the modified group was treated with modified LIFT. The therapeutic effects, clinical relevant indexes, anal function and recurrence were compared between the two groups. Results There were no significant differences in the total effective rate of treatment and the recurrence rate between the two groups(P >0.05). The amount of intraoperative bleeding in the modified group was less than that in the thread-drawing group, the intraoperative wound area in the modified group was smaller than that in the thread-drawing group, and the duration of pain, length of hospital stay and wound healing time were shorter than those in the thread-drawing group(P <0.05). At 3 months after operation, the Wexner score of the modified group was lower than that of the thread-drawing group(P<0.05). Conclusion Modified LIFT has equivalent efficacy with incision and thread-drawing in the treatment of complex anal fistula, but modified LIFT can effectively protect the anal function and promote disease recovery, without increasing the postoperative recurrence rate.