Retrospective Cohort Study On Anal Function After Anal Fistula Seton

Objective:Through retrospective cohort study,the postoperative anal function of anal fistula patients who underwent cutting thread-drawing operation and non-cutting thread-drawing operation were retrospectively analyzed,and the postoperative recurrence of the two groups of patients was collected to observe the influence of traditional Chinese medicine thread-drawing therapy on anal function and postoperative recurrence.Methods:The medical history data of anal fistula patients hospitalized in the anorectal department of our hospital from November 2018 to January 2019 were collected.Patients who met the exclusion criteria were selected for retrospective cohort study.The patients underwent cutting thread drawing as the exposure factor and recurrence as the study endpoint.The patients were divided into cutting thread-drawing group and non-cutting thread-drawing group according to the operations performed during their previous hospitalization.The anorectal dynamic index,anal incontinence score,anal finger diagnosis and relapse data of the two groups of patients before and 3 months after operation were collected and analyzed statistically.Result:Anorectal dynamics index: Through non-inferiority test,the anal tube resting pressure,anal tube maximum systolic pressure,anal mean systolic pressure,sphincter function length,initial sensory capacity and maximum tolerance capacity of the cutting thread-drawing group are no worse than those of the non-cutting thread-drawing group 3 months after operation,and there is no statistical difference between the two groups before operation.Through chi-square test,there was no statistical difference in anorectal inhibitory reflex between cutting thread-drawing group and non-cutting thread-drawing group before and 3 months after operation.(2)Through chi-square test,there was no statistical difference in anal incontinence scores between the cutting thread-drawing group and the non-cutting thread-drawing group before and 3 months after operation.(3)Through chi-square test,there is no statistical difference in the anal finger diagnosis between the cutting thread-drawing group and the non-cutting thread-drawing group before and 3 months after operation.(4)Recurrence: 3 cases recurred in the non-cutting thread-drawing group 3 months after operation,including 2 cases treated with drainage thread-drawing method and 1 case treated with relaxation thread-drawing method.Conclusion:Through this retrospective cohort study,we can see that the anorectal dynamics related indexes in the cutting thread-drawing group are no worse than those in the non-cuttingthread-drawing group after operation,and the anal incontinence score and anal finger diagnosis are not significantly different from those in the non-cutting thread-drawing group.No recurrence was found in the cutting thread-drawing group after operation.This shows that the use of traditional Chinese medicine thread-drawing therapy in the treatment of high anal fistula can reduce the postoperative recurrence rate,preserve the anal function and improve the postoperative quality of life of patients.