| Background:Anal fissure is a common disease in anorectal department.Patients with intractable anal fistula may have severe pain and it lasts for a long time,bringing great pain to patients and affecting their life.Surgery has always been a further option for drug therapy.Lateral internal sphincterotomy(LIS)is still a common surgical method for the treatment of intractable anal fissure,which can improve the quality of life of patients.However,its open wound surface is easy to be stimulated,resulting in heavy postoperative pain and long wound healing time.How to avoid or reduce the shortcomings of open wounds is a problem that needs to be solved in LIS surgery.Objective:In order to reduce the postoperative wound pain and long wound healing time caused by LIS surgery,a subcutaneous latent internal sphincter amputation operation based on the principle of LIS surgery was proposed to observe its efficacy and the incidence of postoperative complications,providing a basis for clinical improvement of anal fissure surgeryMethods:Remove the factors that need to be excluded,and select 30 patients who meet the diagnostic criteria of stage ? and ? anal fissures.They were randomly divided into the experimental group and the control group,experimental group use Lateral and posterior subcutaneous internal sphincterotomy surgery way,control group adopts lateral internal sphincterotomy operation method.Observe and record the operation time,intraoperative blood loss,and postoperative pain of the two groups of patients(the duration of pain on the day after the operation;the degree of pain on the 1st.3rd.7th.and 14th days after the operation;The degree of pain in the anus during the first defecation).the postoperative bleeding of the first defecation,postoperative wound infection,postoperative anal morphology,postoperative anal function,wound healing time,hospital stay,and postoperative recurrence.The data of the observation results of the two groups were analyzed statistically using the spss26 software.Results:All the patients in the experimental group and the control group were recovered,the cure rate was 100%,and no adverse events occurred;Intraoperative bleeding in the experimental group and control group were 5.00±1.89ml and 8.50±1.58ml,t=-4.836,P=0.001<0.05,there was a significant difference between the two groups,and the intraoperative bleeding was significantly reduced in the experimental group;Bleeding in the first postoperative stool of the experimental group and the control group were:3 cases without bleeding,12 cases with mild bleeding,0 case with moderate bleeding,0 case with severe bleeding and 1 case with no bleeding,9 cases with mild bleeding,5 cases with moderate bleeding,0 case with severe bleeding,P=0.021<0.05,there were significant differences between the two groups,and the first postoperative defecation bleeding in the experimental group was significantly reduced;The pain level of the experimental group and the control group on day 1 after surgery were:0 case with ? degree of pain,6 cases with II degree of pain,9 case with ? degree of pain,0 case with ? degrees of pain and 2 case with I degree of pain,12 cases with ? degree of pain,1 case with ? degree of pain,0 case with IV degrees of pain,P=0.073>0.05,there was no significant difference between the two groups;The pain level of the experimental group and the control group on day 3 after surgery were:0 case with ? degree of pain,15 cases with ? degree of pain,0 case with ? degree of pain,0 case with ? degrees of pain and 0 case with I degree of pain,7 cases with ? degree of pain,8 case with ? degree of pain,0 case with ? degrees of pain,P=0.001<0.05,there was a significant difference between the two groups,and the pain of the experimental group was significantly reduced on the third day after the operation;The pain level of the experimental group and the control group on day 7 after surgery were:5 case with ? degree of pain,10 cases with ? degree of pain,0 case with ? degree of pain,0 case with ? degrees of pain and 0 case with ? degree of pain,12 cases with II degree of pain,3 case with III degree of pain,0 case with IV degrees of pain,P=0.005<0.05,there was a significant difference between the two groups,and the pain in the experimental group was significantly reduced on the 7th day after the operation;The pain level of the experimental group and the control group on day 14 after surgery were:12 case with ? degree of pain,3 cases with ? degree of pain,0 case with ? degree of pain,0 case with ? degrees of pain and 5 case with ? degree of pain,9 cases with ? degree of pain,? case with ? degree of pain,0 case with IV degrees of pain,P=0,010<0.05;there was a significant difference between the two groups.The pain of the experimental group was significantly relieved on the 14th day after the operation;The wound healing time of the experimental group and the control group was 13.8012.18 days and 17.27±2.37 days,t=-3.573,P=0.003<0.05,there were significant differences between the two groups,and the postoperative wound healing time of the experimental group was significantly shortened;The operation duration of the experimental group and the control group were 19.0018.90 minutes and 21.27±4.76 minutes,t=-1.005,P=0.332>0.05,there was no significant difference between the two groups,and the operation time of the two groups was about the same;The distribution of the duration of anal pain in the experimental group and the control group was:1 case of no pain,6 cases of mild pain,5 cases of moderate pain,3 cases of severe pain and 0 cases of no pain,5 cases of mild pain,8 cases of moderate pain and 2 cases of severe pain,P=0.640>0.05,there was no significant difference between the two groups;There was no infection on the postoperative wound surface of the experimental group and the control group,the infection rate was 0%,p>0.05,there was no significant difference between the two groups;There was no defect or deformity of anus in the experimental group and the control group,p>0.05,there was no significant difference between the two groups;Postoperative anal function scores of the experimental group and the control group were:13 people with 0 points,2 people with 1 point,and 12 people with 0 points,3 people with 1 point,P=0.630>0.05,there was no significant difference between the two groups;There was no recurrence in the experimental group and the control group after the operation,and the recurrence rate was 0%,P>0.05,there was no significant difference between the two groups;The length of hospitalization was 8.00±2.67 days in the experimental group and 9.00±2.48 days in the control group,t=-1.153,P=0.268>0.05,there was no significant difference between the two groups.Conclusion:Lateral and posterior subcutaneous internal sphincterotomy in the treatment of chronic anal fissure has the same effect as the traditional LIS surgery,but it can reduce postoperative pain,shorten the wound healing,and reduce the injury and pain caused by the operation. |
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