The Clinical Reserch Of Acellular Dermal Matrix Anal Fistula Plug Treatment Simple Anal Fistual

Objective To observe and evaluate the clinical efficacy and safety of acellular dermal matrix anal fistula plug in the treatment of simple anal fistula,and to explore a new minimally invasive surgery for anal fistula,which is suitable for the clinical treatment of anal fistula in anorectal surgery.Methods During the period from August 2015 to February 2017,patients admitted to the Department of anorectal surgery in Anhui traditional Chinese medicine hospital,40 patients who met the diagnostic criteria of simple anal fistula and aged 18~70 years were divided into two groups: treatment group and control group.After preoperative preparation and combined spinal-epidural anesthesia,the treatment group was treated with acellular dermal matrix anal fistula plug,while the control group was treated with simple anal fistula resection or incision and thread.The difference of cure rate,recurrence rate,postoperative pain,postoperative urinary retention,postoperative infection,postoperative bleeding,length of hospital stay,operative time,wound healing time,anal function and anus morphology were observed.The patients were followed up for 6 months.Results1?There was no significant difference in the cure rate and recurrence rate between the two groups(P>0.05),the curative effect is equal.2?After treatment of the two groups,the VAS score in the treatment group was superior to the control group(P<0.05).The duration of postoperative pain in the treatment group was significantly lower than that in the control group(P<0.01).3?There were urinary retention and bleeding cases in both groups after operation.There were no significant difference between the two groups(P>0.05),and there no infection occurred in the two groups after the operation.4?The difference of hospitalization,operation and wound healing time between the two groups was significant.The treatment group was better than the control group(P<0.01).5 ? There was no significant difference in preoperative Wexner incontinence score between the two groups(P>0.05).The end points of postoperative follow-up in both groups were compared with those before operation,there was no significant difference in treatment group(P>0.05),and there was significant difference in the control group(P<0.05).There was significant difference between the two groups in the end of follow-up(P<0.05),and the treatment group had more advantages.6?There was no significant difference in anorectal manometry between the two groups before operation(P>0.05).After operation,the two groups were compared with those before operation,there was no significant difference in the results of the treatment group(P>0.05),but the results of control group were significantly different(P<0.05).There was significant difference between the two groups postoperative(P < 0.01),and the treatment group had more advantages.7?Comparison of the normal rate of anus form after operation in two groups,treatment group is superior to control group(P<0.05).8?No rejection was found in the treatment group.Conclusion Comparison of acellular dermal matrix anal fistula plug in the treatment of simple anal fistula,there was no significant difference in cure rate,recurrence rate,postoperative urinary retention,postoperative infection and postoperative bleeding,but it can obviously alleviate pain,shorten hospitalization time,reduce wound healing time and anal function injury.It has the advantages of simple operation,quick wound recovery,minimal injury,slight pain,good protection of anal function and morphology,safety and no sequelae and so on,which is worthy of further popularizing and application in clinic.