Comparison of the effects of transanal sphincterotomy and incision and thread-hanging method on the recovery of anal function and recurrence in patients with high anal fistula
Objective To explore the clinical efficacy of transanal sphincterotomy and incision and thread-hanging method in the treatment of high anal fistula and its impact on the recovery of anal function and recurrence in patients.Methods 91 patients with high anal fistula were divided into the transanal sphincter incision group(50 cases)and the incision and thread-hanging group(41 cases)based on different surgical methods.The patients in the transanal sphincter incision group were treated with transanal sphincterotomy,while the patients in the incision and thread-hanging group were treated with incision and thread-hanging.Comparison was made on the clinical efficacy,clinical indicators(surgical time,healing time,intraoperative bleeding volume,and hospitalization time),visual analogue scale(VAS)score and Wexner score,anal function,and recurrence between the two groups.Results After treatment,the total clinical effective rate of 96.00%in transanal sphincter incision group was higher than 78.05%in incision and thread-hanging group(P＜0.05).The surgical time of transanal sphincter incision group was(58.98±3.71)min,the healing time was(22.24±1.71)d,and the hospitalization time was(9.38±1.59)d,which were shorter than(75.73±2.95)min,(27.44±1.86)d,and(14.73±2.05)d in incision and thread-hanging group;and the intraoperative bleeding volume of(84.96±2.85)ml was less than(96.07±2.71)ml in incision and thread-hanging group(P＜0.05).At 1 month after surgery,both VAS scores and Wexner scores decreased in both groups,with a greater decrease in the transanal sphincter incision group[(1.54±0.61)and(1.22±0.42)points]compared to the incision and thread-hanging group[(2.17±0.70)and(1.93±0.82)points](P＜0.05).After 3 months of surgery,the maximum systolic pressure and resting pressure of the anal canal in both groups decreased.The maximum systolic pressure and resting pressure of the anal canal in transanal sphincter incision group[(16.23±1.62)and(8.03±1.01)kPa]were higher than those in incision and thread-hanging group[(11.17±1.78)and(4.38±0.92)kPa](P＜0.05).Conclusion Compared to the incision and thread-hanging method,the clinical efficacy of transanal sphincterotomy in high anal fistula is more ideal,which can effectively promote patient recovery,reduce patient pain,and protect patients'anal function.
High anal fistulaIncision and thread-hanging methodTransanal sphincterotomyAnal function
万方数据
维普
