The Clinical Observation Of Modified Anal Fistula Incision Seton Operation In The Treatment Of High Anal Fistula

Objective: Anal fistula refers to a kind of abnormal pipeline that is communicated with the skin around the anus and Formed by pathology.The incidence of anal fistula in high anal fistula in more and more high,surgery is the most effective way for the treatment of high anal fistula.Anal fistula incision seton operation that is the treatment of high anal fistula is the most commonly used.Although the hanging line therapy is chronic cutting muscle,but it still has some effect on anal function.Now how to cure the disease and maximum retent the anal sphincter function is the direction of our research.By comparing the modified incision and thread anal fistula with traditional incision and thread the treatment of high anal fistula postoperative cure rate,recurrence rate,postoperative pain score,hospitalization time and postoperative anorectal function,to evaluate the clinical efficacy of modified fistula incision seton operation in the treatment of high anal fistula.Methods: 80 patients met the inclusion criteria of high anal fistula patients were randomly divided into treatment group and control group,40 cases in each group.The statistical test,the two groups in age,sex,anal fistula type,p>0.05,the difference was not statistically significant.Two groups of patients were comparable(see table1,table2,table3).The treatment group was treated with modified high anal fistula incision and thread,the control group used the traditional anal fistula incision and thread.Mainly from the postoperative cure rate(4 weeks),the recurrence rate(6 months postoperation),postoperative pain,hospitalization time and postoperative anorectal function score,we observe and analyze the treatment effect of the two groups..Results:1 The overall cure rate(4 weeks after surgery)and the long-term recurrence rate of the patients in the study group(6 months after surgery)were compared(see table table4,table5).In the treatment group,40 cases were cured,improved and ineffective in0 cases,the total cure rate was 100%.In the control group,27 cases were cured,improved in 11 cases,ineffective in 2 cases,the total cure rate was 95%.the treatment group received a follow-up visit of 6 months,cured by a total of39 people,with a recurrence of 1 patients,the recurrence rate was 2.5%;Patients in the control group were followed up for 6 months,with a total of 37 patients and a recurrence of 3,the recurrence rate was 7.5%.Two groups in the overall cure rate and long-term recurrence rate(after the operation of 6months)by Fisher exact test,p>0.05,in the cure rate and the recurrence rate is no significant difference.2 Comparison of postoperative pain between the two groups(table6)The pain scores were compared between the treatment group and the control group at 24 hours after operation,the rank sum test,p<0.05,the difference was statistically significant.The pain of the treatment group was lower than that of the control group at 24 hours.3 Comparison of hospitalization time between two groups(table7)Two groups of postoperative hospitalization time compared with the t test(the data of the two groups were in line with normal distribution and homogeneity of variance),the difference was statistically significant(p<0.05),the treatment group was significantly shorter than the control group.4 After 4 weeks of surgery,the comparison of the anal sphincter function and the value of anal indications in the two groups(Table8)By comparing the two groups of patients with anal sphincter function and anal index score in the 4 weeks after surgery,the rank and inspection,p<0.05,the difference was statistically significant.The anal function of the treatment group was significantly better than that of the control group at 4 weeks after operation.Conclusions:1 The clinical efficacy of improved anal fistula incision and thread and conventional anal fistula Seton incision and thread were satisfactory.2 The improved anal fistula incision and thread more effectively reduces postoperative pain than the traditional anal fistula incision and thread.3 The improved anal fistula incision and thread was shorten the hospitalization time than the traditional anal fistula incision and thread significantly.4 The improved anal fistula incision and thread can better protect the anal sphincter function than the traditional anal fistula incision and thread.