Clinical Application Study Of Modified Closed PLIS In Treating Chronic Anal Fissure In Adults

Objective: To study the clinical efficacy,complications and safety of modified closed PLIS versus closed LIS in the treatment of adult chronic anal fissure.Methods:Study subjects: From January 2020 to December 2021,212 patients with chronic anal fissure were hospitalized and operated on in the anorectal ward of the First Affiliated Hospital of Xinjiang Medical University.The experimental method of retrospective analysis was used.And divided into two groups on the basis of the surgical methods.The patients in the experimental group(the modified closed PLIS group,n= 115)and the control group(the closed LIS group,n= 97).The observation indicators included:operation time,amount of bleeding during operation,pain score after operation(24hours),total effective rate,number of days in hospital after operation,number of days in hospital.Follow up the two groups of patients after operation: bleeding,wound infection or split,urinary retention,wound edema,anal stenosis,difficulty in defecation,recurrence and other complications.The Wexner(anal incontinence)scores were collected 1 week,1 month,and 6 months after surgery.To analyze and compare data statistically.Results: Compared with the control group,the experimental group had less bleeding(P= 0.002,P< 0.05),lower postoperative pain score(P< 0.001),shorter healing time(P< 0.001),and lower incidence of urinary retention(P= 0.032,P< 0.05).There was no statistically significant difference between the two groups in their postoperative Wexner(anal incontinence)scores(P= 0.924,P> 0.05).Intragroup pairwise comparison showed significant differences in scores between the two groups at 1 week and 1 month after surgery(P< 0.001),and at 1 week and 6 months after surgery(P< 0.001).There was no significant difference between the two groups in surgical time,effective rate,length of stay,length of stay after surgery,and other complications(P> 0.05).Conclusion:Modified closed PLIS has the advantages of faster wound recovery,more gently postoperative pain,fewer postoperative complications,and good safety.In the treatment of chronic anal fissure in adults,it can,based on anatomical basis,reduce anal pressure to a greater extent,relieve sphincter spasm,alleviate ischemia,reduce edema,and promote wound healing.It can be used as a suitable choice for the treatment of chronic anal fissure in adults.