Clinical Study Of Treatment Of High Simple Anal Fistula With Tunnel Stripping Drainage And The Inner Ligation In Zhilou Lotion

Objective Based on the concept of minimally invasive,by observing the differences in surgical efficacy,postoperative complications,wound healing time,change of anal canal dynamics,anal function,contrast tunnel stripping drainage and the inner ligation and traditional anal fistula incision hangs line in the treatment of the advantages and disadvantages of high simple anal fistula,thus a more optimal solution to explore the clinical treatment of anal fistula.Methods 60 cases of high simple fistula that meet diagnostic criteria will be included,divided into treatment group and control group randomly.The treatment group(30 cases)was treated with fistula tunnel stripping drainage and the inner ligation combined with ZHILOU lotion,and the control group(30 cases)was treated with traditional anal fistula Seton combined with ZHILOU lotion.Through observation,records,analysis of two groups of patients in surgical curative effect,the postoperative complications(pain,drainage,itching,postoperative urinary retention),wound healing time,change of anal canal dynamics(anal resting pressure,anal canal maximum systolic blood pressure),anus function(the anus dre and anal incontinence Wexner integral)and after 3 months follow-up,statistical processing,draw the conclusion.Results Clinical efficacy: there was no statistically significant difference between the two groups in the cure rate and the inefficiency of follow-up 3 months after the operation(P >0.05).Postoperative complications:(1)pain: there was a difference between the two groups on day 1,3 and 9 after the surgery(P <0.05).(2)exudation: there existed a difference in exudation between the two groups on the 1st,3rd and 9th day after the operation(P <0.05).The exudation in the treatment group at all observation points was lighter than that in the control group.(3)itching: there was no difference between the two groups in the itching condition on the first day after the operation(P >0.05),and no anal itching was observed in the two groups.There was a difference in the degree of itching on day 3 and 9(P <0.05).(4)postoperative urination: urinary retention was found in both groups during surgical urination,with no statistically significant difference(P >0.05).Wound healing time: there was a difference in postoperative wound healing time between the two groups(P <0.05),and the treatment group was faster than the control group in wound healing time obviously.Anal dynamics:(1)anal resting pressure: the difference of anal resting pressure before and after surgery in the treatment group(P >0.05)was not statistically significant.The difference of anal resting pressure before and after operation in the control group was statistically significant(P<0.05).The difference of postoperative anal resting pressure between the two groups(P <0.05)was statistically significant.(2)the maximum systolic pressure before and after surgery in the treatment group(P >0.05)was not statistically significant.The difference of the maximal systolic pressure before and after operation in the control group was statistically significant(P <0.05).The difference of maximal systolic pressure between the two groups was statistically significant(P <0.05).Anal function:(1)anal finger score: there was a difference in postoperative anal finger score between the two groups(P <0.05),and the treatment group was better than the control group.(2)Wexner score of anal incontinence: there was a difference in Wexner score of postoperative anal incontinence between the two groups(P<0.05),and the treatment group was better than the control group.Conclusion Compared with traditional anal fistula Seton combined with ZHILOU lotion operation,fistula tunnel stripping drainage and the inner ligation combined with ZHILOU lotion showed many advantages: clear curative effect,low recurrence rate,less postoperative pain,low degree of postoperative complications,shorter healing time,and higher protection rate of perianal muscle and anal function.The observation of clinical efficacy of this subject can provide a basis for further exploration and promotion of minimally invasive anal fistula surgery.