经肛括约肌间切开术(transanal opening of intersphincteric space,TROPIS)是治疗复杂性肛瘘的新术式,该术式通过经肛入路,使用电刀切开括约肌间瘘管上的黏膜和内括约肌,不切断外括约肌,彻底搔刮干净所有瘘管,清除外括约肌两侧的感染,具有手术操作简单、术后创面愈合快、患者疼痛小、肛门功能恢复良好等优点,值得临床推广.但关于TROPIS的术后并发症及具体处理措施较少见文献报道,笔者团队曾收治1例TROPIS术后腹膜后感染(罕见并发症)的病例,现将其治疗过程及并发症处理方案报告如下,与同道交流.
Abstract
The transanal opening of intersphincteric space(TROPIS)is a new surgical procedure for the treatment of complex anal fistula.This procedure involves accessing the fistula through the anus,using an electrocautery knife to inci-sion the mucosa and internal sphincter above the fistula between the sphincters without disconnecting the external sphincter.All fistulas are thoroughly scraped clean,and the infection on both sides of the external sphincter is cleared.TROPIS has the advantages of simple surgical operation,rapid healing of the postoperative wound,less patient pain,and good recovery of anal function,making it worthy of clinical promotion.However,there are few reports in the literature regarding postoperative complications and specific treatment measures for TROPIS.Our team has treated a rare case of retroperitoneal infection(a rare complication)following TROPIS surgery.We report the treatment process and complica-tion management plan here for communication with colleagues.
关键词
腹膜后感染/经肛括约肌间切开术/术后并发症/临床诊疗
Key words
retroperitoneal infection/transanal opening of intersphincteric space/postoperative complications/clinical diag-nosis and treatment