Clinical Study Of The Transanal Opening Of Intersphincteric Space(TROPIS) For Fistula-in-ano

Objective: To observe the clinical safety and effectiveness of Transanal Opening of Intersphincteric Space For Fistula-in-ano.Evaluate its clinical promotion value and promote the development of traditional anorectology in the motherland.Methods: This topic passed the observation and analysis of the interview and analysis of the interviews of the teacher and related literature.From January2020 to September 2020,60 hospitalized cases of the Anorectal Department of the hospital who meet the inclusion criteria of this study will be selected for prospective research.According to the random number method,they were divided into treatment group and control group with 30 cases each.Under the same perioperative management method,the observation group underwent Transanal Opening of Intersphincteric Space,The control group underwent traditional anal fistula incision and thread drawing,and the following indicators were analyzed and compared:(1)Intraoperative blood loss;(2)Wound pain score on the 1st,3rd,7th,and 14 th days after surgery;(3)The incidence of postoperative adverse reactions;(4)Total cure rate and recurrence rate;(5)Total healing days;(6)Total hospitalization costs;(7)Anal 3D manometer score,anal incontinence score,long-term adverse reaction score.Statistical analysis was performed through SPSS 26.0 software,and the differences between the two groups were analyzed and compared.To explore the clinical effectiveness and safety of transanal intersphincterotomy and whether it has clinical promotion value.Results: 1.The baseline data of the two groups of patients are comparable.The comparison of the age,gender,course of disease,preoperative anal incontinence score,preoperative anal 3D pressure measurement results,and comorbidities between the two groups is not statistically significant and comparable.(P>0.05)2.The intraoperative blood loss of the two groups of patients was not statistically significant(P>0.05),indicating that the intraoperative blood loss of the two groups was similar.3.Comparing the perioperative pain scores of the two groups of patients,there was no significant difference in the pain scores on the first day after surgery(P>0.05),and the comparison of the pain scores between the two groups on the 3rd,7th,and 14 th day,the comparison between the two groups on the 7th day was statistically significant(P<0.05);the comparison between the two groups on the 3rd and 14 th day was statistically significant(P<0.01),indicating that the pain after the Tropis operation was lighter and relieved quickly after surgery.4.Comparison of the incidence of adverse reactions during the perioperative period between the two groups was not statistically significant(P>0.05).Moreover,the difference in long-term adverse reaction scores between the two groups was not statistically significant(P>0.05),which may be related to the small sample size or the unclear expression of the patients at the time of statistics.5.Comparing the total recovery rate of the two groups of patients,there was no statistically significant difference(P>0.05).At the same time,the comparison of the recurrence rate of the two groups showed that the difference was not statistically significant(P>0.05).The recovery rate and recurrence rate of open thread surgery are similar.6.Comparing the anal incontinence score and anal 3D pressure measurement results between the two groups at 3 months after operation,it was found that the Tropis operation group was better than the incision and thread-drawing group(P<0.05).At the same time,comparing within the group,the difference in the Tropis operation group was not statistically significant(P>0.05),while the difference in the incision and thread-drawing group was statistically significant(P<0.05),indicating that Tropis surgery has a significant advantage in protecting the anus function compared with traditional incision and thread-drawing.7.The difference in wound healing time between the two groups of patients was statistically significant(P<0.01),indicating that the wound healing in the Tropis group was significantly faster than the incision and thread-drawing group.8.Comparing the hospitalization expenses of the two groups of patients,there was no statistically significant difference between the two groups(P>0.05).Conclusion: Tropis surgery has the characteristics of low recurrence rate on the basis of ensuring the cure rate.less postoperative pain,fast healing,and protection of anal function.It has the advantages of ensuring the quality of life of patients after surgery,has clinical safety and stability,and is worthy of clinical application.