Clinical study of complex anal fistula treated by endorectal mucosal advancement flap combined with fistulectomy
Objective To investigate the clinical outcome of complex perianal fistulas treated by mucosal advancement flap(MF)combined with fistulectomy(FT).Methods Totally,208 patients with complex perianal fistulas were treated.According to patients'own intention,110 patients were operated by MF combined with FT(MF & FT group),and 98 patients were treated by FT combined with seton(FT group).All patients were assessed retrospectively by case-note review and examined at the out-patient clin-ic.The localization and time of recurrence of the fistula were recorded and defecation function was deter-mined.The t-test was used for the comparison of measurement data,and the chi-square test was used for the comparison of count data.Results The patients in the two groups were followed up for 24-48 months after operation.After 12,24,and 48 months,the fistula had recurred in 9(8.2％),20(18.2％),and 23(21.0％)patients of the MF & FT group,and 25(25.5％),41(41.9％),and 47(48.0％)patients of the FT group,respectively(x2=4.087,4.586,5.740,P＜0.05).The curative rate was 80.9％(89/110)in the MF& FT group,and 49.0％(48/98)in the FT group after surgery 24 months(x2=3.517,P＜0.05).There were 9(8.2％)patients with defecation dysfunction in the MF&FT group and 36(36.7％)patients with defecation function in the FT group after operation(x2=6.627,P＜0.05).Conclusion The curative rate of complex anal fistula treated by mucosal advancement flap combined with fistulectomy increases in comparison with fistulectomy after operation.Recurrence and defecation dysfunc-tion appear to be decreased by this treatment.
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