The Clinial Study Of Retained The Internal Sphincter And Drainage Seton Method Of Treatment Of Low Sphincter Fistula

Background:Anal fistula is an ancient and common diseases in anorectal surgery. Anal fistula which has endostoma、external aperture and fistula is an abnormal pipeline which communicates with anal canal、rectum and the skin around the anus. It often formed by Anal gland infection. Chinese medicine called as "anal leakage".Low anal fistula clinical is still commonly used incision, the intestine in the feces, intestinal bacteria and other infectious agents, but the cut is easy to enter the wound, affecting the growth of granulation, resulting in faster wound healing of the anal margin, anal canal, granulation growth slower, larger wound, healing time is longer, easy to produce anal defects, pseudo-healing, to bring greater suffering to the patient. In addition, studies have shown that the integrity of the integrity of the external anal sphincter, internal sphincter reflex, anal local epithelial electrophysiological feel the scar tissue caused by the anal canal defect is a major factor affecting the anus restraint function. Therefore, on this basis, we have designed retaining the internal sphincter muscle, and removal of part of the endostoma then partially closed and virtual hanging drainage to solve the part of the above problems, in order to comply with the new trend of modern surgical minimally invasive and functional protection.Objective:On the basis of cure anal fistula, minimize the incidence of anal canal defects, protection homemade anal function, to avoid pseudo-healing, shorter hospital stays as much as possible to reduce patient suffering, improve quality of life.Methods:Select30cases to meet the requirements of low sphincter anal fistula patients, divided into two groups:the experimental group and control group. Treatment group with Retaining the internal sphincter muscle, and removal of part of the endostoma then partially closed and virtual hanging drainage control group anal incision. Evaluation, including wound healing, postoperative wound healing, scar size, anal exhaust and loose stools, dry control, the degree of pain in patients, the wound secretions, urinary retention, and so on.Results:Treatment group compared with the control group, age, gender, the total effect, the recurrence rate, postoperative pain and urinary retention difference not statistically significant (P>0.05), postoperative anal function score, wound healing time differences statistically significant (P<0.05).Conclusion:Retaining the internal sphincter muscle, and removal of part of the endostoma then partially closed and virtual hanging drainage for treatment of low sphincter anal fistula in the cure rate, relapse rate with the traditional incision and drainage fairly. There is no obvious advantage in the improvement of wound pain and secretions. However, in the maintenance of anal function, and decreased wound healing time aspects show significant advantages.