Broadly,complex fistulas are those that are not low transsphincteric or intersphincteric. The objectives of surgical management are to achieve fistula healing,prevent recurrences and maintain continence. The risk of i...Broadly,complex fistulas are those that are not low transsphincteric or intersphincteric. The objectives of surgical management are to achieve fistula healing,prevent recurrences and maintain continence. The risk of incontinence associated with treatment ranges from10% to 57%. The objective of this manuscript is to review the current literature to date on the ligation of the intersphincteric fistula tract procedure(LIFT procedure) as a treatment option in these types of fistula.A search was conducted in Medline,PUBMED,EMBASE and ISI Web of Knowledge,and studies published from January 2009 to May 2013 were included. The primary outcomes were fistula healing rates,mean healing time and patient satisfaction with this surgical technique.Eighteen studies were included in this review. The total number of patients included was 592(65% male).The median age reported was 42.8 years. The most common type of fistula included was transsphincteric(73.3% of cases). The mean healing rate reported was74.6%. The risk factors for failure discovered were obesity,smoking,multiple previous surgeries and the length of the fistula tract. The mean healing time was5.5 wk,and the mean follow-up period was 42.3 wk.The patient satisfaction rates ranged from 72% to 100%. No de novo incontinence developed secondary to the LIFT procedure. There is not enough evidence that variants in the surgical technique achieve better outcomes(Bio-LIFT,LIFT-Plug,LIFT-Plus). This review indicates that the LIFT procedure is primarily effective for transsphincteric fistulas with an overall fistula closure of 74.6% and has a low impact on fecal continence. This procedure produces better outcomes at the first surgical attempt.展开更多
Complex anal fistulas are difficult to treat.The main reasons for this are a higher recurrence rate and the risk of disrupting the continence mechanism because of sphincter involvement.Due to this,several sphincter-sp...Complex anal fistulas are difficult to treat.The main reasons for this are a higher recurrence rate and the risk of disrupting the continence mechanism because of sphincter involvement.Due to this,several sphincter-sparing procedures have been developed in the last two decades.Though moderately successful in simple fistulas(50%-75%healing rate),the healing rates in complex fistulas for most of these procedures has been dismal.Only two procedures,ligation of intersphincteric fistula tract and transanal opening of intersphincteric space have been shown to have good success rates in complex fistulas(60%-95%).Both of these procedures preserve continence while achieving high success rates.In this opinion review,I shall outline the history,compare the pros and cons,indications and contraindications and future application of both these procedures for the management of complex anal fistulas.展开更多
Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pu...Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.展开更多
目的探讨经括约肌间瘘管结扎(ligation of intersphincteric fistula tract,LIFT)术治疗低位单纯性肛瘘的临床疗效。方法选取2020年2月至2023年2月连云港市东海县中医院收治的低位单纯性肛瘘患者46例。采用随机数字表法分为对照组和观察...目的探讨经括约肌间瘘管结扎(ligation of intersphincteric fistula tract,LIFT)术治疗低位单纯性肛瘘的临床疗效。方法选取2020年2月至2023年2月连云港市东海县中医院收治的低位单纯性肛瘘患者46例。采用随机数字表法分为对照组和观察组,各23例。对照组采用传统肛瘘切开术,观察组采用LIFT术,比较两组患者的临床疗效及术后恢复情况。结果两组患者总有效率无显著差异(P=0.310)。观察组患者创面愈合时间、住院时长均短于对照组,视觉模拟评分法评分低于对照组,差异均有显著性(P<0.05)。两组患者术前肛门失禁Wexner评分无显著差异,术后1个月、术后3个月,观察组患者肛门失禁Wexner评分均较对照组低,差异有显著性(P<0.05)。结论LIFT术治疗低位单纯性肛瘘,能够在一定程度上减轻患者痛苦,保留患者括约肌功能,患者恢复更快。展开更多
Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract,whilst preserving the sphincters and the mechanism of continence.For the simple and most distal fistulae,conven...Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract,whilst preserving the sphincters and the mechanism of continence.For the simple and most distal fistulae,conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore,well accepted in clinical practise.However,for the more complex fistulae where a significant proportion of the anal sphincter is involved,great concern remains about damaging the sphincter and subsequent poor functional outcome,which is quite inevitable following conventional surgical treatment.For this reason,over the last twodecades,many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function.Among them,the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula.Another technique,the anal fistula plug,derived from porcine small intestinal submucosa,is safe but modestly effective in long-term follow-up,with success rates varying from 24%-88%.The failure rate may be due to its extrusion from the fistula tract.To obviate that,a new designed plug(GORE BioA ) was introduced,but long term data regarding its efficacy are scant.Fibrin glue showed poor and variable healing rate(14%-74%).Fi La C and video-assisted anal fistula treatment procedures,respectively using laser and electrode energy,are expensive and yet to be thoroughly assessed in clinical practise.Recently,a therapy using autologous adiposederived stem cells has been described.Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae,and studies remain in progress.The aim of this present article is to review the pertinent literature,describing the advantages and limitations of new sphincterpreserving techniques.展开更多
Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears th...Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.展开更多
Fistula-in-ano is a difficult problem that physicians have struggled with for centuries.Appropriate treatment is based on 3 central tenets: (1) control of sepsis;(2) closure of the fistula;and (3) maintenance of conti...Fistula-in-ano is a difficult problem that physicians have struggled with for centuries.Appropriate treatment is based on 3 central tenets: (1) control of sepsis;(2) closure of the fistula;and (3) maintenance of continence.Treatment options continue to evolve-as a result,it is important to review old and new options on a regular basis to ensure that our patients are provided with up to date information and options.This paper will briefly cover some of the traditional approaches that have been used as well as some newer promising procedures.展开更多
目的:探讨超声引导下静脉属支结扎法(UGLVB)在动静脉内瘘功能不良的血液透析患者中的疗效和安全性。方法:回顾性分析2018-01-01~2022-09-30在北京市海淀医院肾脏内科行静脉属支结扎患者的一般临床资料、手术方案、术后并发症等。将患者...目的:探讨超声引导下静脉属支结扎法(UGLVB)在动静脉内瘘功能不良的血液透析患者中的疗效和安全性。方法:回顾性分析2018-01-01~2022-09-30在北京市海淀医院肾脏内科行静脉属支结扎患者的一般临床资料、手术方案、术后并发症等。将患者分为传统切开结扎术式组(切开结扎组)和UGLVB组,比较两组基线资料、手术成功率、手术时间、伤口愈合时间及并发症、内瘘通畅情况、治疗费用等情况。结果:入选共44例患者,UGLVB组19例、传统切开结扎术式组25例。静脉属支结扎最常见的原因是主干流量不足(84.09%),结扎的静脉属支最多见的是头静脉背侧属支(54.55%)。两组在年龄、性别、基础肾脏病、共患疾病、透析龄、内瘘龄、内瘘启用时间、静脉属支结扎原因和部位上差异均无统计学意义。手术均获成功,UGLVB组伤口愈合时间低于切开结扎组(2.42±0.51 d vs 12.72±1.49 d,t=-32.256,P=0.000)。并发症方面,切开结扎组有1例出现切口愈合不良,UGLVB组2例、切开结扎组1例出现伤口局部少量渗血,切开结扎组有1例出现神经损伤。两组均未出现严重出血、感染等严重不良事件。结论:UGLVB与传统切开结扎术式在静脉属支结扎术的成功率和并发症方面无明显差异,在减少手术创伤和伤口愈合方面优于传统术式,是一种安全、有效、微创的临床操作方法。展开更多
目的探讨经直肠推移瓣术(endorectal advancement flap,ERAF)联合括约肌间瘘结扎术(ligation of the intersphincteric fistula tract,LIFT)治疗高位单纯型肛瘘的临床疗效。方法选取2022年3—9月北京市肛肠医院(北京市二龙路医院)高位...目的探讨经直肠推移瓣术(endorectal advancement flap,ERAF)联合括约肌间瘘结扎术(ligation of the intersphincteric fistula tract,LIFT)治疗高位单纯型肛瘘的临床疗效。方法选取2022年3—9月北京市肛肠医院(北京市二龙路医院)高位单纯型肛瘘住院患者84例,按照随机数字表法分为观察组和对照组,每组42例。观察组采用ERAF联合LIFT,对照组采用传统切除挂线术。比较治疗后两组视觉模拟评分(visual analogue scale,VAS)、临床疗效及并发症情况。结果84例患者中,男58例、女26例,年龄27~59岁,平均(32.6±6.8)岁。观察组术后第1天、第3天、第7天的VAS低于对照组[(5.24±1.08)分比(7.19±1.35)分,(4.76±1.11)分比(6.21±1.09)分,(2.34±0.54)分比(2.98±0.61)分],出血量、住院时间及伤口愈合时间低于对照组[(7.83±1.62)ml比(12.66±2.46)ml,(3.75±1.66)d比(4.55±1.71)d,(28.15±8.65)d比(39.12±10.23)d],术后2个月Wexner评分及肛管收缩压低于对照组[(3.28±0.63)分比(4.46±0.75)分,(178.49±8.82)mmHg比(186.22±10.29)mmHg,1 mmHg=0.133 kPa],肛管静息压高于对照组[(45.88±2.87)mmHg比(43.85±1.74)mmHg],并发症发生率低于对照组(11.90%比33.33%),差异均有统计学意义(P<0.05);两组手术时间的比较,差异无统计学意义(P>0.05)。结论相较于传统肛瘘切除挂线术,ERAF联合LIFT具有患者出血量少、痛苦小、病程短、恢复快等优点,值得临床推广。展开更多
目的评价经括约肌间瘘管结扎术(ligation of the intersphincteric fistula tract,LIFT)联合直肠推移瓣术(endorectal advancement flap,ERAF)治疗高位复杂性肛瘘的临床疗效。方法2016年8月~2021年12月我院收治的高位复杂性肛瘘病人40例...目的评价经括约肌间瘘管结扎术(ligation of the intersphincteric fistula tract,LIFT)联合直肠推移瓣术(endorectal advancement flap,ERAF)治疗高位复杂性肛瘘的临床疗效。方法2016年8月~2021年12月我院收治的高位复杂性肛瘘病人40例,根据抽签法随机分成试验组和对照组,每组各20例。试验组采用LITF+ERAF,对照组采用LIFT,随访6~12个月,比较其临床疗效,比较创面愈合时间、治愈率、术后第1天疼痛程度、肛门功能和复发率。结果两组术后第1天疼痛程度、创面愈合时间、治愈率比较差异无统计学意义(P>0.05)。两组术前、创面愈合后、术后6个月的Wexner肛门失禁评分、肛管静息压和肛管最大收缩压比较差异无统计学意义(P>0.05);两组创面愈合后、术后6个月的肛管静息压和肛管最大收缩压分别与其自身术前比较,差异有统计学意义(P<0.05)。随访6~12个月,试验组无复发,对照组复发3例,差异有统计学意义(P<0.05)。结论LITF联合ERAF疗效好、痛苦小、病程短、术后复发率低、肛门功能影响小。展开更多
文摘Broadly,complex fistulas are those that are not low transsphincteric or intersphincteric. The objectives of surgical management are to achieve fistula healing,prevent recurrences and maintain continence. The risk of incontinence associated with treatment ranges from10% to 57%. The objective of this manuscript is to review the current literature to date on the ligation of the intersphincteric fistula tract procedure(LIFT procedure) as a treatment option in these types of fistula.A search was conducted in Medline,PUBMED,EMBASE and ISI Web of Knowledge,and studies published from January 2009 to May 2013 were included. The primary outcomes were fistula healing rates,mean healing time and patient satisfaction with this surgical technique.Eighteen studies were included in this review. The total number of patients included was 592(65% male).The median age reported was 42.8 years. The most common type of fistula included was transsphincteric(73.3% of cases). The mean healing rate reported was74.6%. The risk factors for failure discovered were obesity,smoking,multiple previous surgeries and the length of the fistula tract. The mean healing time was5.5 wk,and the mean follow-up period was 42.3 wk.The patient satisfaction rates ranged from 72% to 100%. No de novo incontinence developed secondary to the LIFT procedure. There is not enough evidence that variants in the surgical technique achieve better outcomes(Bio-LIFT,LIFT-Plug,LIFT-Plus). This review indicates that the LIFT procedure is primarily effective for transsphincteric fistulas with an overall fistula closure of 74.6% and has a low impact on fecal continence. This procedure produces better outcomes at the first surgical attempt.
文摘Complex anal fistulas are difficult to treat.The main reasons for this are a higher recurrence rate and the risk of disrupting the continence mechanism because of sphincter involvement.Due to this,several sphincter-sparing procedures have been developed in the last two decades.Though moderately successful in simple fistulas(50%-75%healing rate),the healing rates in complex fistulas for most of these procedures has been dismal.Only two procedures,ligation of intersphincteric fistula tract and transanal opening of intersphincteric space have been shown to have good success rates in complex fistulas(60%-95%).Both of these procedures preserve continence while achieving high success rates.In this opinion review,I shall outline the history,compare the pros and cons,indications and contraindications and future application of both these procedures for the management of complex anal fistulas.
文摘Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.
文摘目的探讨经括约肌间瘘管结扎(ligation of intersphincteric fistula tract,LIFT)术治疗低位单纯性肛瘘的临床疗效。方法选取2020年2月至2023年2月连云港市东海县中医院收治的低位单纯性肛瘘患者46例。采用随机数字表法分为对照组和观察组,各23例。对照组采用传统肛瘘切开术,观察组采用LIFT术,比较两组患者的临床疗效及术后恢复情况。结果两组患者总有效率无显著差异(P=0.310)。观察组患者创面愈合时间、住院时长均短于对照组,视觉模拟评分法评分低于对照组,差异均有显著性(P<0.05)。两组患者术前肛门失禁Wexner评分无显著差异,术后1个月、术后3个月,观察组患者肛门失禁Wexner评分均较对照组低,差异有显著性(P<0.05)。结论LIFT术治疗低位单纯性肛瘘,能够在一定程度上减轻患者痛苦,保留患者括约肌功能,患者恢复更快。
文摘Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract,whilst preserving the sphincters and the mechanism of continence.For the simple and most distal fistulae,conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore,well accepted in clinical practise.However,for the more complex fistulae where a significant proportion of the anal sphincter is involved,great concern remains about damaging the sphincter and subsequent poor functional outcome,which is quite inevitable following conventional surgical treatment.For this reason,over the last twodecades,many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function.Among them,the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula.Another technique,the anal fistula plug,derived from porcine small intestinal submucosa,is safe but modestly effective in long-term follow-up,with success rates varying from 24%-88%.The failure rate may be due to its extrusion from the fistula tract.To obviate that,a new designed plug(GORE BioA ) was introduced,but long term data regarding its efficacy are scant.Fibrin glue showed poor and variable healing rate(14%-74%).Fi La C and video-assisted anal fistula treatment procedures,respectively using laser and electrode energy,are expensive and yet to be thoroughly assessed in clinical practise.Recently,a therapy using autologous adiposederived stem cells has been described.Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae,and studies remain in progress.The aim of this present article is to review the pertinent literature,describing the advantages and limitations of new sphincterpreserving techniques.
文摘Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.
文摘Fistula-in-ano is a difficult problem that physicians have struggled with for centuries.Appropriate treatment is based on 3 central tenets: (1) control of sepsis;(2) closure of the fistula;and (3) maintenance of continence.Treatment options continue to evolve-as a result,it is important to review old and new options on a regular basis to ensure that our patients are provided with up to date information and options.This paper will briefly cover some of the traditional approaches that have been used as well as some newer promising procedures.
文摘目的:探讨超声引导下静脉属支结扎法(UGLVB)在动静脉内瘘功能不良的血液透析患者中的疗效和安全性。方法:回顾性分析2018-01-01~2022-09-30在北京市海淀医院肾脏内科行静脉属支结扎患者的一般临床资料、手术方案、术后并发症等。将患者分为传统切开结扎术式组(切开结扎组)和UGLVB组,比较两组基线资料、手术成功率、手术时间、伤口愈合时间及并发症、内瘘通畅情况、治疗费用等情况。结果:入选共44例患者,UGLVB组19例、传统切开结扎术式组25例。静脉属支结扎最常见的原因是主干流量不足(84.09%),结扎的静脉属支最多见的是头静脉背侧属支(54.55%)。两组在年龄、性别、基础肾脏病、共患疾病、透析龄、内瘘龄、内瘘启用时间、静脉属支结扎原因和部位上差异均无统计学意义。手术均获成功,UGLVB组伤口愈合时间低于切开结扎组(2.42±0.51 d vs 12.72±1.49 d,t=-32.256,P=0.000)。并发症方面,切开结扎组有1例出现切口愈合不良,UGLVB组2例、切开结扎组1例出现伤口局部少量渗血,切开结扎组有1例出现神经损伤。两组均未出现严重出血、感染等严重不良事件。结论:UGLVB与传统切开结扎术式在静脉属支结扎术的成功率和并发症方面无明显差异,在减少手术创伤和伤口愈合方面优于传统术式,是一种安全、有效、微创的临床操作方法。
文摘目的评价经括约肌间瘘管结扎术(ligation of the intersphincteric fistula tract,LIFT)联合直肠推移瓣术(endorectal advancement flap,ERAF)治疗高位复杂性肛瘘的临床疗效。方法2016年8月~2021年12月我院收治的高位复杂性肛瘘病人40例,根据抽签法随机分成试验组和对照组,每组各20例。试验组采用LITF+ERAF,对照组采用LIFT,随访6~12个月,比较其临床疗效,比较创面愈合时间、治愈率、术后第1天疼痛程度、肛门功能和复发率。结果两组术后第1天疼痛程度、创面愈合时间、治愈率比较差异无统计学意义(P>0.05)。两组术前、创面愈合后、术后6个月的Wexner肛门失禁评分、肛管静息压和肛管最大收缩压比较差异无统计学意义(P>0.05);两组创面愈合后、术后6个月的肛管静息压和肛管最大收缩压分别与其自身术前比较,差异有统计学意义(P<0.05)。随访6~12个月,试验组无复发,对照组复发3例,差异有统计学意义(P<0.05)。结论LITF联合ERAF疗效好、痛苦小、病程短、术后复发率低、肛门功能影响小。
