| Background:Anal fistula is a common disease in Department of anus & intestine surgery, the incidence rate and high recurrence rate, has become a difficult disease in Department of anus & intestine surgery. The treatment of anal fistula is to protect the anal function, but also to reduce the risk of recurrence after operation. Anal fistula operation way, traditional incision Seton method has the advantages of simple operation, amount of bleeding less, but wound healing for a long time, there is a risk of anal incontinence and a key hole abnormal; retention sphincterotomy because almost no damage to the anal muscles, to maximize the protection of the anal sphincter function, gradually become the research hotspot in recent years.Objective:From the cure rate, anal self-control function, postoperative pain, wound healing time compared with lateral mucosa/skin flap preserved sphincter surgery and conventional incision and thread drawing therapy in the treatment of the anal sphincter advantages and disadvantages, looking for from the greatest extent protect the anal sphincter, anal continence function and shorten the wound healing time, improve the patients quality of life, reduce complications of operation.Methods:To select the line with the cases of inclusion criteria,30 cases of transsphincteric fistula patients with simple random number table were randomly divided into the treatment group (n=15), and 15 patients as control group. In the treatment group, the patients were treated with lateral shift mucosa and skin flap, and the control group was treated with traditional incision and thread technique.Results:(1) in the treatment group and control group after the cure rate was 100%, the difference is not statistically significant, and lateral displacement of mucosa/skin flap preserving sphincter surgery and traditional cut hanged line operation in the treatment of anal fistula quite. (2) postoperative bleeding score, postoperative urinary retention score, postoperative 3 day pain score, the treatment group were lower than the treatment group, the difference was statistically significant. (3) in the treatment group and the control group, the anal function score was 0 points before operation, and no difference was not significant. After three months, the self-made function score of the treatment group was lower than that of the control group, the difference was statistically significant. Control group before and after the operation in three months, the difference was statistically significant between the anal self function score, the treatment group before and after the operation in three months, the difference was not statistically significant. (4) the average healing time of the treatment group was 35.47±55 days, while the average healing time was 52.33±12.80 days in the control group, the difference of the two groups had statistical significance. (5) the average cost of hospitalization in the treatment group was 1.89±0.38 ten thousand yuan, the average cost of hospitalization in the control group was 1.75±0.43 ten thousand yuan, the difference was not statistically significant. (6) in the treatment group, the average operation time was 54.33±14.62 minutes, the average operation time was 49.33±24.85 minutes, the difference between the two groups was not statistically significant. (7) patients in the treatment group were followed up for 3 months (15 months),0 cases relapsed,2 cases in control group and 15 cases in the control group.Conclusion:Using lateral mucosa/skin flap reserved sphincterotomy to treat the anal sphincter, does not affect the treatment effect under the premise, can greatly reduce the damage to the anal sphincter, to ensure the normal anal continence. Shorter wound healing time and improve the patient’s quality of life, postoperative pain can be reduced, to reduce the incidence of complications, but also conforms to the concept of rapid rehabilitation surgery is a good protection of anal function, curative effect is satisfactory sphincter preserving surgery in the new method. |
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