The Clinical Study Of Therapy For Low Fistula By Mucosa Advancement Flap Anoplasty And Marsupialization

Background:Anal fistula is the short title of anal and rectal fistula,which is the chronic and pathological tunnel between anal skin and anus or rectum.It often formed by perianal abscess burst or incision and drainage.Cryptoglandular infection is the major factor.Low fistula-in-ano,which accounts for about 70%, consists of the low transsphincteric and low intersphincteric anal fistula.At present, For low anal fistula,there are incision, excision, excision and suture or half suture et al.Except for female anterior anal fistula requiring retained sphincter muscle methord, analfistulotomy is used mostly.But after the incision, infection material such as excrement, intestinal juice and bacteria easily to enter the wound, which influences granulation tissue growth, causes anal canal wound granulation tissue growing more slowly. Meanwhile the wound is larger and healing time is longer, easily produce anal defects, pseudo healing and bring greater pain for patients. In order to resolve these problems, this subject designs the mucosa advancement flap anoplasty and marsupialization treatment technique.Objective:On the basis of eradicating anal fistula as far as possible to shorten healing time, reduce the incidence of anal defect, avoid spurious healing, reduce pain, improve the quality of life.Methods:30 patients with low simple anal fistula were included in the study,of whichl5 cases underwent the fistula incision, mucosa advancement flap anoplasty and marsupialization (the study group),whilel5 cases underwent the analfistulotomy (controll group). Then compare with curative rate, rate of recurrence, healing time, complications(postoperative ache, retention of urine, bleeding,function of anal continence.et al),postoperation wound area,postoperation scar area between two groups and the wound area between analfistulotomy and mucosa advancement flap anoplasty with marsupialization in the study group.Results:two groups have no statistic differences in age, sex distribution, curative rate, rate of recurrence,postoperative ache,wexner grading of anal incontinence,retention of urine (P>0.05). There is obvious statistic significance in the postoperative bleeding,postoperation wound area,postoperation scar area between the two groups and the wound area between analfistulotomy and mucosa advancement flap anoplasty with marsupialization in the study group (P＜0.05).Conclusion:mucosa advancement flap anoplasty with marsupialization treatment technique is effective in eradicating the low anal fistula.It has the merit that shorten course of treatment,reducing the incidence of anal defect, improving the quality of life.