Clinical Study Of Cutting Of Intersphincter Space Based On The Mechanism Of Intersphincter Infection In The Treatment Of High Anal Fistula

Objective:Through a randomized controlled study of Cutting of intersphincter space and traditional Cutting seton in the treatment of high anal fistula,to evaluate the efficacy,safety and superiority of Cutting of intersphincter space in the treatment of high anal fistula,so as to provide new ideas and techniques for the treatment of high anal fistula,so that this technique can be widely used in the clinical diagnosis and treatment of high anal fistula.Methods:From January 2019 to August 2020,72 patients with high anal fistula who were admitted to the anorectal Center of Nanjing Hospital of traditional Chinese Medicine with surgical indications and met the inclusion and exclusion criteria of the study were selected.They were randomly divided into experimental group(Cutting of intersphincter space)and control group(Cutting seton)with 36 cases in each group.The overall clinical effect,postoperative pain score,anal function,wound area,wound healing time,hospital stay,recurrence rate and the incidence of postoperative complications were compared between the two groups.Results:There was no significant difference in overall clinical efficacy and recurrence rate between the two groups(all P>0.05).In terms of pain score,at the first defecation after operation,at the 7th and 14th day after operation,the pain score in the test group was lower than that in the control group(all P<0.05).The postoperative anal resting pressure and anal maximum contractile pressure in the test group were higher than those in the control group(all P<0.05).The scores of fecal incontinence and anal digital examination in the experimental group were lower than those in the control group at 3 and 6 months after operation(all P<0.05).In terms of wound area,the wound area in the test group was smaller than that in the control group on the postoperative day,the 7th and 14th day after operation(all P<0.05).The wound healing time and hospital stay in the test group were shorter than those in the control group(all P<0.05).The incidence of postoperative complications in the test group was lower than that in the control group(all P<0.05).Conclusion:Cutting of intersphincter space and Cutting seton are effective methods for the treatment of high anal fistula,the two methods are comparable in overall clinical efficacy and recurrence rate.However,Cutting of intersphincter space has obvious advantages in protecting anal function,reducing postoperative pain,reducing wound area,shortening wound healing time and hospitalization time,and reducing postoperative complications,especially in protecting anal function and reducing surgical trauma.Cutting of intersphincter space is safe and effective in the treatment of high anal fistula and can be widely used in clinic.