| Objective:Through the design of star-shaped drainage incision,compared with the traditional fusiform drainage incision,the effect of star-shaped incision on scar,anal shape and function after high anal fistula was investigated by evaluating the anal function and scar degree after operation.Methods:From December 2018 to May 2019,40 patients with anal fistula who hospitalized in the anorectal department of Nanjing traditional Chinese Medicine Hospital were randomly divided into observation group and control group,20 cases each,among which the anal margin of observation group was star drainage incision,and the control group was conventional fusiform radial incision drainage.the postoperative wound area and area reduction rate(Image J software),wound healing time,anal function(Wexner score),scar growth(patient and observer scar assessment scale,POSAS)and postoperative recurrence were observed and compared between the two groups.At the last follow-up,the patients were shown two pictures of surgical scars,which were selected as a kind of scar and compared with patients' satisfactionResults:(1)There was no significant difference in age,sex,preoperative anal function function evaluation,wound area and the wound area after the day of operation(P>0.05);(2)There was no significant difference in wound area change and the reduction rate of wound scar area between the two groups on the 7th day after operation(P>0.05).1 month,3 months and 6 months after operation,the wound scar area in the observation group was significantly smaller than that in the control group,and the reduction rate of wound scar area in the observation group was significantly higher than that in the control group(P<0.05);(3)The wound healing time between the observation group and the control group was statistically significant(P<0.05)after examination.The results showed that the healing time of observation group was less than that of the control group;(4)There was no significant difference between the two groups in the evaluation of anal function before treatment(P>0.05),indicating that there was no significant difference in anal function,but there was a significant difference in anal function scores between the two groups in the third and sixth months after operation(P<0.05);(5)Anal scar was evaluated by patient and observer scar assessment scale(POSAS)in the two groups after 3 months and 6 months of operation.The postoperative scar growth in the observation group with star incision was significantly better than that in the control group(P<0.01);(6)The recurrence was recorded at the 6th month follow-up of the two groups.Because of the small sample size,the difference between the two groups was not statistically significant(P>0.05),which indicated that there was no significant difference in postoperative recurrence between the two groups,and the total effective rate of the observation group and the control group was 95%and 90%,respectively.Conclusion:There was no significant difference in scar area,rate of change and overall recurrence rate between the high anal fistula operation with star drainage incision and the traditional fusiform incision.However,the scar area and change rate of the wound in the third and sixth months after star incision were significantly better than that of fusiform incision Compared with traditional surgical incision,star surgical incision can shorten wound healing time,reduce scar formation,beautify scar appearance,maintain the original shape of anus,maintain anal function better,improve the quality of life of patients,improve clinical efficacy,easy clinical application,can be popularized in hospitals at all levels,and provide new ideas for surgical treatment of high anal fistula. |
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