Clinical study on the treatment of anal fistula by transsphincter fistulectomy / 中国基层医药

ABSTRACT

Objective:To investigate the clinical effect of transsphincter fistulectomy in the treatment of anal fistula.Methods:Seventy-three patients with anal fistula who received treatment in Zhoushan Hospital from March 2016 to March 2020 were included in this study. They were randomly assigned to undergo either conventional incision combined with thread-drawing drainage (control group, n = 35) or transsphincter fistulectomy (observation group, n = 38). Operative time, wound healing time, length of hospital stay, Visual Analogue Scale (VAS) score 24 and 48 hours after surgery, complications, the improvement in anal sphincter function before and 3 months after surgery were compared between the two groups. Results:Operative time, wound healing time and length of hospital stay in the observation group were (49.83 ± 7.67) minutes, (20.78 ± 3.54) days and (5.31 ± 1.27) days, which were significantly shorter than those in the control group [(62.31 ± 5.45) minutes, (25.87 ± 3.10) days, (7.78 ± 1.32) days, t = 8.063, 6.512, 8.133, all P < 0.05). The VAS score 24 and 48 hours after surgery in the observation group were (2.43 ± 0.64) points and (1.21 ± 0.36) points, respectively, which were significantly lower than those in the control group [(3.87 ± 1.23) points, (2.83 ± 0.97) points, t = 6.347 and 9.607, both P < 0.05]. The incidence of complication in the observation group was significantly lower than that in the control group [5.26% (2/38) vs. 28.57% (10/35), χ2 = 7.206, P < 0.05]. Conclusion:Transsphincter fistulectomy in the treatment of anal fistula has good therapeutic effects, can reduce pain and has little impact on the function of anal sphincter. It is innovative and scientific.