Study On The Clinical Efficacy Of Fistula Undermining Dissection Combinated With Seton Drainage Of Internal Opening On Posterior Horseshoe Anal Fistula

Objective:To study the clinical efficacy of fistula undermining dissection combinated with seton drainage of internal opening on posterior horseshoe anal fistula. So as to compare to the conventional surgical therapy of incision cutting section drainage and selective suture. Our aim of this project is to prove the feasibility of fistula undermining dissection combinated with seton drainage of internal opening on posterior horseshoe anal fistula.Methods:Fifty patients with posterior horseshoe anal fistula who met the inclusion criteria,were randomly divided into treatment arm (n=25) and control arm (n=25).The treatment arm received fistula undermining dissection combinated with seton drainage of internal opening while the control arm received incision cutting section drainage and selective suture.To observe the curative effects,postoperative complications, sequela, anal function and recurrence in follow-up period in two arms.Result:The two arms were all clinical cured,and no recurrence was found in follow-up during six month.There was no significant difference in wound healing time and urinary retention(P>0.05).However,there was significant difference in postoperative pain in first day and seventh day (P <0.05), the treatment arm tend to suffer less pain than the control arm.The treatment arm had better outcomes than the control arm in aspects of maintaining anorectal pressure,nomal anal morphology,and protecting anal function.Conclusion:Compared with conventional surgical therapy of incision cutting section drainage and selective suture,fistula undermining dissection combinated with seton drainage of internal opening on posterior horseshoe anal fistula have the similar cure rate.But it may has advantages such as less postoperative pain,better appearance of anus and protection of anal function.