Ligation of intersphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula: A Meta-analysis / 国际外科学杂志

ABSTRACT

Objective To systematically investigate the clinical efficiency and safety of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Methods Searched PubMed,The Cochrane Library,CNKI,WanFang Data,and VIP from inception to May 2016,to collect randomized controlled trials of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Search term included ligation of inter sphincteric fistula tract,fistula,incision-thread-drawing procedure,randomized controlled trial.The literatures were screened according to inclusive criteria,data were extracted and the quality of included studies was evaluated,and then meta-analysis was performed using RevMan 5.2 soft ware.A total of 5 randomized controlled trials including 305 patients were included.Results The results of meta-analysis showed that compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract had a significant difference in amount of bleeding during surgery (MD =-18.30,95％ CI-19.91 ～-16.69,P ＜ 0.000 01),the duration of pain (MD =-4.38,95％ CI-4.69 ～-4.08,P ＜ 0.000 01),healing time (MD =-10.28,95％ CI-15.71 ～-4.86,P =0.0002),hospital stay (MD =-7.44,95％CI-10.87～-4.02,P＜0.000 1),recurrence rate (OR=0.31,95％CI0.10～0.91,P=0.03).There was no significant difference in Operation time (MD =-5.83,95 ％ CI-7.64 ～-4.02,P ＜ 0.000 01),effective percentage (OR =4.35,95％ CI0.89 ～ 21.32,P =0.07) between both groups.Conclusion Compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract shows significant advantage in cure rate,postoperative healing time,reducing post-operation pain,anal function protection and recurrence rate.