| Background Anal fistula is a common clinical disease,which is easy to recur and seriously affects patients’ work and life.Surgery is the main means to cure anal fistula.For the treatment of low simple anal fistula,there are many options for surgery,and incision method is widely used in clinical practice.However,sphincterotomy still affects the anal function to a certain extent,especially for the anal fistula in the anterior part with relatively weak sphincter,it is more prudent to incision the sphincter.Thread-drawing is a common method in the treatment of such anal fistulas.It can effectively protect the anal sphincter by using the chronic cutting effect of thread-drawing,it may lead to mild damage of anal function,keyhole-like deformity,large scar area and other adverse conditions.How to carry forward the advantages of thread-drawing therapy and overcome the shortcomings of thread-drawing therapy is a problem that we need to explore and solve constantly.Objective:through clinical observation of modified button thread-hanging therapy in the treatment of anterior low simple anal fistula,to objectively evaluate the advantages and disadvantages of modified thread-hanging therapy in further reducing postoperative complications of anal fistula and protecting anal function,so as to provide new ideas for continuous innovation and improvement of directional thread-hanging therapy in clinic.Methods:40 patients with anal fistula were randomly divided into two groups:the experimental group and the control group.The experimental group was treated with modified buttoning technique,the control group was operated with modern rubber band.The patient was informed of the modified procedure and its difference from the modern rubber band before the operation,and the operation was performed with the patient’s informed consent.the dropping time of seton,the degree of anal pain(postoperatively and the1,3,5,7 days after the thread tightening),the time of wound healing,postoperative anal morphology and anal function,and the recurrence rate of anal fistula were recorded.SPSS Statistics 25 data analysis software was used to compare and analyze the two groups of data.Results:1.The general data:the age,sex and course of disease were compared between the two groups,there was no difference between the two groups(P>0.05).2.various observation indexes after operation:the cure rate,wound healing time,thread dropping time,postoperative recurrence and hospitalization days were,there was no significant difference(P>0.05).3.various observation indexes after operation:the anal shape,keyhole-like deformity and anal function,there was statistically significant(P<0.05).The modified thread-drawing group was superior to the modern rubber band thread-drawing group in terms of anal shape and anal function protection.4.Postoperative pain:on the first day after operation,the first and third days after thread tightening,the pain difference between the two groups was statistically significant(P<0.05).The pain of the modified button thread-tying group was greater than that of the modern rubber band thread-tying group.On the 3rd,5th and 7th day after operation and the 5th and 7th day after suture tightening,there was no significant difference in postoperative pain between the two groups(P>0.05).Conclusion:Compared with modern rubber band thread-tying,the improved button thread-tying therapy can effectively reduce the occurrence of anal deformity and better protect anal function.The efficacy of surgery is similar to that of surgery.However,the postoperative pain is relatively severe,which needs further research and improvement. |
PDF Full Text Request