The Clinical Research Of Therapy For Trans-sphincteric Fistula By Tunnel Rotary-cutting And LIFT

Objective:To study the clinical efficacy for trans-sphincteric fistulas by tunnel rotary-cutting and LIFT(ligation of the inter-sphincteric fistula tract),and try to find a new surgical procedure in a case of ensuring the curative effect of less sphincter damage,and accumulate clinical data for minimally invasive surgery of the anal fistula.Methods:The current study was conducted by Prof.Wang Yehuang at the Third Affiliated Hospital of Nanjing University of Chinese Medicine between September 2015 and February 2017.There are 15 patients in experimental group and 15 patients in control group through voluntary principle.The experimental group is treated with the tunnel rotary-cutting and LIFT and the control group with LIFT.Reeord postoperative wound secretion,pain,infection,healing time and therapeutic outcome.All patients were followed up after at least 3 months.Results:(1)After 3 months,complete wound healing was achieved in 14 patients(93.33%)in experimental group and 12 patients(80.00%)in control group(P=0.435).(2)There was a significant difference in the degree of wound secretion on the 1st postoperative day(P=0.002).There was a difference on the 4th postoperative day(P=0.021).There was no difference on the 7th postoperative day(P=0.559).(3)There was a significant difference in the degree of anal pain on the 1st postoperative day(P=0.006).There was no difference on the 4th and 7th postoperative day(P>0.05).(4)There was no significant difference in the degree of anal infection on the 1st 4th and 7th postoperative day(P>0,05).(5)The two groups had differences at the wound healing time(P=0.038).(6)After 3 months,all patients' subjective symptoms of anal function and Anal morphology were normal(100%).Conclusion:The operation which Tunnel rotary-cutting and LIFT cured trans-sphincteric fistulas was security and minimally invasive.Ensuring the curative effect at the same time,the operation to alleviate wound secretion and anal pain in patients,shorten the healing time and save the complete anal function.lt deserves further research for clinical using.