外括约肌裸化的瘘管切除术治疗经括约肌型肛瘘患者46例疗效观察

Fistulectomy with external anal sphincter bareness in treatment of trans-sphincteric anal fistula:clinical analysis of 46 cases

回顾性分析2018年7月至2019年7月浙江中医药大学附属嘉兴中医院肛肠外科,采用外括约肌裸化的瘘管切除术治疗46例经括约肌型肛瘘患者的临床资料。所有患者手术顺利,手术时间(41.0±7.3)min;创面愈合时间4~6周,术后切口发生出血1例、感染2例,均经搔刮、清创、换药后愈合。术前及术后6个月Wexner失禁评分分别为(2.00±0.68)和(1.99±0.70)分,肛门静息压分别为(75.60±8.60)和(73.60±8.20)mmHg(1 mmHg=0.133 kPa),最大收缩压分别为(109.60±7.80)和(107.20±8.30)mmHg,手术前、后比较差异均无统计学意义(均P>0.05)。随访6个月无复发及肛门形态变化情况。提示外括约肌裸化的瘘管切除术治疗经括约肌型肛瘘安全、有效,并保留括约肌。

Clinical data of 46 patients with trans-sphincter anal fistula treated by fistulectomy with external anal sphincter bareness in Department of Anorectal Surgery,Jiaxing TCM Hospital from July 2018 to July 2019 were retrospectively analyzed.All operations were performed successfully.There were no significant differences in Wexner incontinence scores(2.00±0.68 vs.1.99±0.70,P<0.05),mean anal resting pressure[(75.60±8.60)vs.(73.60±8.20)mmHg(1 mmHg=0.133 kPa),P<0.05]and maximum systolic pressure[(109.60±7.80)vs.(107.20±8.30)mmHg,P<0.05]before and 6 months after operation.There were 1 case with postoperative incision bleeding and 2 cases with postoperative infection.All patients were followed up for 6 months and there was no recurrence and changes in anal shape during the follow-up.Results indicate that the fistulectomy external anal sphincter bareness is safe,efficient with well preserved sphincter function for patients with trans-sphincter anal fistula.