Clinical Study On The Effect Of Closure Of The Internal Opening By Stapler And Rectal Mucosal Flap In The Treatment Of Closed Internal Mouth

Objective:To observe the clinical curative effect of internal opening cut inside the mouth closed closed in the treatment of anal fistula.Methods:September 2014-2017 February 30 cases of anal fistula surgical treatment by traditional Chinese Medicine Hospital of Nanjing City,in accordance with the principle of voluntary were divided into two groups,experimental group(n=15)by internal opening excision closed treatment,the control group(n=15)by rectal mucosal flap over treatment.The two groups were compared after the operation of the internal mouth closed,closed mouth operation time,postoperative pain,foreign body sensation and other indicators;observe the experimental group in the anastomosis of the nail anastomosis and postoperative residual titanium screws(visible).According to the score records,the results of the treatment were analyzed and evaluated,and the curative effect,safety and so on.Result:(1)there was no significant difference between the two groups in the analysis of gender and age data(P>0.05).The results showed that the two groups were statistically comparable.(2)observed after 3 days,7 days,14 days,the growth of two groups of granulation,internal orifice and mouth infection showed no significant difference(P>0.05),that after 3 days,7 days,14 days,the experimental group and the control group in the export growth closed have no obvious difference.In the experimental group,the operation time was 5-9 minutes,and the control group was 5-12 minutes.The operation time of the two groups was not statistically significant(P>0.05).After 3 days,on the 7 day,and on the 30 day,there was no significant difference between the scores of the patients in the two groups,and there was no significant difference in the scores of foreign body sensation(P>0.05).The results show that the effect of closure of the internal opening by stapler is similar to that of the incision and internal fixation of the rectal mucosa,and there is no significant difference in the degree of pain and foreign body sensation.(3)In the experimental group after surgery incision,excision closed after the formation of the anastomotic nail all molding,which only 1 cases with active bleeding incision,and anastomosis edge will be removed in the mouth of all failed to agree,bleeding edge.After 7 days and 30 days after operation,the patients of the experimental group were found to have the titanium nail falling off within 7 days after the operation.All the titanium nails in the anastomosis of the patients in the 30 days after the operation of the experimental group were all dropped off,and there was no residual titanium nail in 15 cases.It shows that the internal incision is safe and does not have the problem of residual titanium nail.Conclusion:the effect of internal incision and closure is similar to that of rectal mucosa,and it has the advantages of pain,foreign body sensation,and operation time.It is indicated that internal resection is a safe and effective minimally invasive surgery,which is worthy of further study.