| Objective:1.to observe the clinical efficacy of trans-s Phincteric interstitial sulcus to blind end incision and hanging wire for high anal fistula.2.To seek a safer and more effective treatment strategy for high sim Ple anal fistula by com Paring the efficacy of trans-s Phincteric sulcus to blind end incision and hanging with that of traditional low incision and high hanging.Methods.From September 1,2021 to September 1,2022,I visited the Affiliated Hospital of Shandong University Institute of Anal Medicine and selected 64 patients with high anal fistula treated in the hospital,randomly divided into a follow-up group and a control group with 32 cases in each group.In the observation group,large anorectal fistulas were treated with a wire suspended from the blind end of the sphincter,whereas in the control group,large normal anorectal fistulas were treated with a small incision and wire suspended from the sphincter.Patients in both groups were followed up from day 1 to 6 months after surgery to assess suture removal time,postoperative pain(VAS),recovery time,Vex urinary incontinence,suture removal time,postoperative complications,overall outcome and recurrence rate,and the results were statistically analysed to draw conclusions.Results.1.A total of four cases,30 in each group,were dislodged during the study due to personal reasons of the patients and inconvenience of review during the epidemic.2.There was no statistically significant difference between the observation and control groups in the com Parison of general data such as age,gender and duration of disease(P>0.05),indicating that the two grou Ps were comparable;both groups had a 100%cure rate and no recurrence cases were seen at the 6-month postoperative follow-up.3.the efficacy of the observation group and the control group was comparable in terms of operative time,Preo Perative VAS score,preoperative anal function Wexenr score,postoperative complications(traumatic discharge,urinary retention,anal swelling,anal stricture),number of tight lines,trauma healing,overall efficacy and recurrence(P>0.05).4.Postoperative VAS scores in both the intervention and control groups decreased over time.The ratio in the intervention group was significantly lower(P = 0.007)compared to the control group on day 1 after surgery(P < 0.01),at 7 days after surgery,the VAS scores in the observation group were significantly lower than those in the control group(P=0.008(P<0.01)),and at 15 days after surgery,the VAS scores of the two groups were almost the same as before surgery,with no significant difference.5.The postoperative Wexenr anal function scores of the observation and control groups decreased over time,and the scores of the observation group were lower than those of the control group at 1 month,3 months and 6 months after surgery(P<0.05),especially the statistical difference was more significant at 1 month after surgery(P<0.01),and the median Wexenr anal function scores of the two groups at 6 months after surgery were 1.00 respectively,which were lower compared with the preoperative scores,with The difference was statistically significant(P<0.05).6.The postoperative healing time was shorter in the observation group than in the control group,with the mean time for complete wound healing in the observation group being 44.20±8.763,shorter than that in the control group of 50.80±15.072,with a statistical difference(P<0.05).Conclusion.In the treatment of high anal fistula,compared with the traditional low incision and high hanging,high anal fistula through the sphincter gap to the blind end incision and hanging is safer and more effective,more significantly reduces postoperative pain,better protects the anal sphincter,reduces the burden of damage and recovery of anal function,reduces the risk of fecal incontinence,coupled with smaller trauma and faster healing,greatly improves patient satisfaction and well-being,and deserves to be widely used and promoted in clinical practice. |
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