Clinical And Experiment Study On The Treatment Of High Complex Anal Fistula (HCAF) By Fenestration And Putting Aside Therapy

Objective: To evaluate the curative effect of the fenestration and putting aside therapy on HCAF and to discuss its mechanism by systematic clinical and experiment study.Methods: Sixty cases of patients were divided randomly into the control group and the treatment group. The former was treated with incision and thread-drawing therapy, and the latter with fenestration and putting aside. A comparative study on clinical curative effect between the control group and the treatment group was conducted by examining the anorectal manometry, MEG of external sphincter muscle of anus, the rectal sensory function and the anal continence function in 20 cases selected from each group randomly.Results:1.Fenestration and Putting aside therapy could shorten the recovery time of the wound, decrease the damage of crissal tissue and postoperative complication, and have a satisfactory long-term function of anal sphincter. It was better than the incision and thread-drawing therapy.2.The items in both groups such as the postoperative anal maximal contraction pressure, the anal rest pressure, the anal relaxant pressure, the amplitude of quiescent wave, the maximal contractile wave of external sphincter of anus, the rectal sensory threshold, the rectal constant volume, thetreatment group had a less declined range compared with the control group(P<0.01). The anal longest contraction time decreased too in both groups but the treatment group was better than the control group(P<0.01).Conclusion: Fenestration and putting aside therapy is a satisfactory surgical method in the treatment of HCAF. It makes use of the anorectal dynamics, and can clean the primary focus of disease thoroughly, protect the function of anal sphincter muscle by reducing the damage of anal sphincter muscle and crissal tissue.