Internal Opening Incision Suture And Video Assisted Fistulas Planing In The Treatment Of High Complex Anal Fistula

Objective:To observe the effect of internal opening incision suture and video assisted fistulas planing in the treatment of high complex anal fistula,and to evaluate the curative effect of this operation,so as to provide evidence for the application of this operative method in clinic.Method:From October 2014 to May 2017,106 cases of high complex anal fistula were treated in the anorectal Department of the Third Affiliated Hospital of Nanjing University of Chinese Medicine.In accordance with the principle of randomization,divided into observation group and control group,the observation group used in fistula resection and suture cutting treatment,the control group used the traditional low incision and high thread drawing therapy,through observation,recording and analysis of two groups of patients with postoperative wound healing time,cure condition,recurrence,postoperative the anal function etc..Follow up data were recorded and processed statistically,and the conclusion was drawn that the assessment of anal function was based on the constipation score scale(Wexner),anal canal resting pressure and anal canal maximum systolic pressure.The follow-up was 4～30(10)months by telephone or network.Results:(1)36 cases were cured,13 cases markedly effective,3 cases were cured,effective rate was 94.2%;the control group cured 33 cases,effective 13 cases,invalid 8 cases,efficiency of 85.2%,said the healing rate of two groups had no statistical difference(P>0.05);(2)the observation group healing time:38.61 within 7.15 days,the control group healing time was 51.72 + 9.25 days,the difference was statistically significant(P<0.01);(3)preoperative Wexner scores of the two groups had no significant difference(P>0.05),postoperative Wexner scores of the two groups were statistically significant difference(P<0.05),and the same group of patients with preoperative and postoperative Wexner score relatively,the observation group had no statistical significance(P>0.05),the control group had statistical significance(P<0.05);(4)the two groups preoperative anal resting pressure and maximum systolic blood pressure showed no significant difference(P>0.05),two groups of postoperative anal resting pressure and maximum systolic blood pressure compared with the No statistical difference(P<0.05),at the same time,the observation group anal resting pressure and maximal systolic pressure before and after surgery had no significant difference(P>0.05),the control group anal resting pressure and maximal systolic pressure before and after surgery were statistically significant difference(P<0.05);(5)postoperative follow-up date of 3 cases of recurrence in the observation group the control group,8 cases of recurrence,no statistical treatment(P>0.05).Conclusion:the effect of internal opening incision suture and fistulas planing in the treatment of high complex anal fistula is accurate,safe and reliable;it can better protect the function of the anus,reduce the wound and promote the healing of the wound.It is a minimally invasive technique and is worthy of clinical promotion.