隧道式瘘管切除肛缘开窗挂线术治疗肛瘘的疗效观察

Observation on the therapeutic efficacy of the tunnel type anal fistula resection and seton through window at the edge of anus in the treatment of anal fistula

目的探讨总结肛瘘改良手术方法的疗效。方法回顾性分析广东省深圳市职业病防治院采用隧道式瘘管切除、肛缘开窗挂线术治疗肛瘘30例病人的临床资料,术式为隧道式切除瘘管瘢痕组织直达接近内口处,在内口相应方位肛门缘开窗,于内口与窗口之间行结扎挂线,于切除瘘管后的瘘管床处行虚挂引流。结果 30例均治愈,治愈率100%。随访0.5~2.0年,无复发,无肛门畸形,无肛门失禁。结论隧道式瘘管切除、肛缘开窗挂线术治疗肛瘘疗效确切,达到了解剖学清除原发病灶的目的,保留瘘管行经范围的皮肤完整性,避免了术后肛周局部外形改变及"锁孔状"缺损。

Objective To summarize the therapeutic efficacy of an improved operation method for anal fistula.Methods Retrospectively analysed the data of 30 patients with anal fistula who accepted the tunnel type anal fistula resection and seton through window at the edge of anus.The step of the operation was to resect scar tissue of the fistula directly close to the entrance of fistula like tunneling,open a window at the edge of anus near the entrance and ligate a rubber band through the window and entrance,hang a string virtually to drainage in the bed of fistula which have been removed.Results 30 cases were all cured,and the cured rate was 100%.Followed-up for 0.5- 2 years,no recurrence,no anus deformity,no anal incontinence.Conclusion The tunnel type anal fistula resection and seton through window at the edge of anus is an effective treatment for anal fistula.It meet the aim of anatomical excision of the primary lesion,keep the skin integrity in the range through fistula,avoid the change in local appearance and keyhole-like incontinence of anus.