Objective:To evaluate the efficacy and safety of transsphincteric fistulotomy combined with seton placement for the management of high complex anal fistulas.Methods:80 patients diagnosed with high complex anal fistulas were randomly divided into two groups,with 40 patients in each group.The treatment group underwent transsphincteric fistulotomy combined with seton placement,while the control group received high ligation of anal fistula tract.The postoperative anal function and clinical efficacy were evaluated by observing local anal symptoms and wound healing time on the 1st,7th,and 14th day after surgery.Results:The effective rate in the treatment group was significantly higher than that in the control group(P<0.05).Compared with the control group,the treatment group showed significantly less bleeding,pain,and sense of anal prolapse on the 1st and 7th day after sugery,and significantly less exudation on the 7th and 14th day after sugery.The Wexner incontinence scores of the treatment group at 3 and 6 months after sugery were significantly lower than those of the control group,indicating statistically significant differences(P<0.05).Furthermore,the anal longest contraction(ALCT)and the anal maximal contraction pressure(AMCP)of the treatment group were significantly higher than those of the control group at the 3 and 6-month postoperative follow-up(P<0.05).Conclusion:Transsphincteric fistulotomy combined with seton placement exhibits remarkable efficacy in the treatment of high complex anal fistulas,resulting in fewer postoperative complications and improved preservation of postoperative anal function.
high complex anal fistulatransanal intersphincterotomyloose seton therapyincision and thread-drawing therapy
维普
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