A Clinical Study Of Partial Sphincter-sparing Surgery In The Treatment Of High Simple Anal Fistula

Objective:To observe the clinical effect of partial sphincter preservation(modified Parks operation)and traditional thread drawing operation in the treatment of high simple anal fistula,and compare the differences in surgical efficacy,postoperative recovery and anal function,so as to explore a better surgical method in the protection of anal function in the treatment of high simple anal fistula.Methods:From February 2020 to October 2020,66 patients with high simple anal fistula were randomly divided into experimental group and control group,33 cases in each group,31 cases in each group.The experimental group was treated with partial sphincter preservation,and the control group was treated with traditional thread drawing.The total effective rate,postoperative wound pain score(VAS score),length of stay,wound healing time,anorectal pressure measurement,anal incontinence function score(Wexner score),anal morphology and recurrence rate in half a year were compared between the two groups.Results:1.There was no significant difference in the total effective rate and recurrence rate of the two groups after 3 months of follow-up(P>0.05).2.Comparison of VAS score of postoperative wound pain: on the first day after operation,there was no statistically significant difference in postoperative wound pain between the two groups(P>0.05);on the 6th and 13 th day after operation,there was statistically significant difference in postoperative wound pain between the two groups(P<0.05).3.Comparison of hospitalization time between the two groups: the average hospitalization time of the experimental group was(15.87±2.31)days,and that of the control group was(16.48±3.29)days,P=0.011,with statistical significance(P<0.05).4.Comparison of wound healing time between the two groups: the average wound healing time of the experimental group was(43.16±4.61)days,and that of the control group was(48.26±4.72)days,the difference was statistically significant(P<0.05).5.Anorectal pressure measurement comparison:3 months after operation,the anal resting pressure and maximum systolic pressure of the experimental group were higher than those of the control group,with statistical significance(P < 0.05).6.There was no anal keyhole deformity in the two groups after 3 months of follow-up.Conclusion:Partial sphincter preservation in the treatment of high simple anal fistula has little difference with traditional thread drawing operation in efficiency and recurrence rate,but is superior to traditional thread drawing operation in postoperative wound pain,hospitalization time,wound healing time and anal function protection.