Clinical Evaluation Of The Treatment Of High Anal Fistula With

Purpose:To format a standard therapy to cure the high anal fistula with the thread- drawing method which is with the high cure rate,less post-operative pain,less hospital stay,and the maximum level of saving the function of anus.In the research we observed and compared the post-operative pain,healing time,ability of controlling the defecation,determination of the anal pressure,post-operative recurrence rate,etc between the low incision high thread drawing method of operation and the the low incision high indwelling method of operation.Material and method:We adopt the 200 patients suffered the high fistula who were treated during the March 2012 to January 2014(all of them were patients stayed in the Shenyang Anorectal hospital),the patients were randomly divided into two observation groups,the two observation groups were experiment group and control group,we compared and observe the both of two groups,and we tracked down all the patients till the six months after the operation.We took the following date as the observation and research information:VAS pain score of the post-operative patients(the VAS pain score that 72 hours after the operation and 168 hours after the operation),the clinical effect evaluation of the post-operation,the condition of the wound surface secretion when the operation was finished 7 days,the anorectal pressure determination(resting pressure and maximum squeeze pressure) of the pre-operation and post-operation,the anal function evaluation of the pre-operation and post-operation,anal Wexner score,recurrence rate of post-operation,etc.Results:After the tracked down observation,we used the statics program calculated and compared the clinic effects of the both groups P>.05,the test has no significant differences;healing time between the two groups has nosignificant differences(P>0.05);used the VAS pain score to evaluate the post-operative pain of the two groups after operation 72 hours and 168 hours,after the calculation and analysis by the statics program,the P-values between the both groups were greater than 0.05,the differences were not statistically significant;compare the condition of the wound surface secretion after 7 days of the operation,calculated by the statics program we found that the difference was not statistically significant,P>0.05;compare the pre-operative and post-operative Wexner scores of the both groups by the static program,the difference between the two groups is not statistically significant,p>0.05;compare anorectal pressure determination between the pre-operative group and the post-operative group,the difference has no significant difference(P>0.05);we followed all the patients six months and compare the recurrence rate between the two groups,compare the data with static program we found that the P value is lesser than 0.05,the difference between the two groups is statistically significant.Conclusion:1.After the comparison and analysis,we found the data of the patients of the experiment group(treated by low incision high thread drawing method of operation) and the control group(treated by low incision high indwelling method of operation) is not statistically different,the observation data included:clinical effect,the condition of the wound surface secretion after 7 days of the operation,post-operative Wexner score.Compared all the above data between the experiment group and control group,we found that the experiment group was not better than the control group in these aspects. 2.Compared the post-operative pain VAS scores between two groups,the control group(treated by low incision high indwelling method of operation)is not much better than the experiment group(treated by low incision high thread drawing method of operation);and in comparison of the healing time,the experiment group is not much better than the control group,in the aspect of shortening time the experiment group didn’t show up the significant advantage. 3.In the observation of the six months tracking down we found that the difference of the recurrence rate between the two groups is significant,the experiment group is much better than the control group. As the common surgery method to treat the high fistula in the clinic,low incision high thread drawing method of operation using the chronic cutting and foreign matter stimulation function of the rubber band,chronically cutting the sphincter while guaranteeing the synchronism of the tissue healing.And it avoided the sudden damage of the sphincter during treating the fistula,guaranteed the integrity of the anorectal angle,protected the anal function by avoiding or reducing the damage of the anorectal loop.The improved low incision high thread drawing method of operation avoids the strong stimulation to the sphincter by using the medium preessure drawned thread,while inheriting the advantages of the original method,it significantly reduced the pain of the treatment.It happened to have the same view with the minimally invassion opinion of the modern surgery.We could recieve the same expectted outcome of therapy on the premise that reduce the issue damage and the pain of patients.In the respect of controling the recurrence rate,as the low incision high thread drawing method of operation is better than the low incision high indwelling method of operation in controling the formation of false lumen,and it throughly cures the disease,so the method of operation has the worth to be extensed.