| Background Condyloma acuminata(CA)is a common sexually transmitted disease caused by human papillomavirus(HPV)infection and is most common in sexually active people.The clinical manifestations are often superfluous genital and perianal skin and mucous membrane;perianal and anal canal warts are more common in men who have sex with men(MSM),the perianal and anal canal anatomical location is special,mucosal folds,rich blood supply,for the human papillomavirus provides a nutritional site,conducive to the reproduction of the virus,and the treatment process is prone to erosion,ulceration,anal stenosis,and other adverse reactions.The actual fact that it is difficult to treat the perianal and anal canal warts and that they are prone to recurrence has been a problem for clinicians.Objective To retrospectively study the clinical effectiveness of 5-aminolevulinic acid photodynamic therapy(5-ALA PDT)combined with Carbon dioxide laser(CO2 laser)therapy and simple C02 laser therapy in the treatment of perianal and intra-anal condyloma acuminatum,to investigate the clinical effectiveness and recurrence rate and to record the adverse reactions,to provide a clinical basis for the clinical treatment of perianal and intraanal warts,reduce the recurrence rate,alleviate the adverse reactions and improve the quality of life of patients.This study provides clinical evidence for the clinical treatment of perianal and intra-anal warts,reduction of recurrence rate,alleviating adverse effects,and improving the quality of life and well-being of patients.Materials and Methods This retrospective study collected patients from the Department of Dermatology,Jiangsu Subei People’s Hospital from September 2020 to June 2022,and 150 patients with perianal and intra-anal condyloma acuminatum who met the criteria were screened.The 75 cases in the study group were treated with 5-aminolevulinic acid photodynamic therapy combined with CO2 laser,while the 75 cases in the control group were treated with CO2 laser alone,with a 6-month postoperative follow-up.The clinical efficacy,recurrence rate,incidence of adverse reactions,and factors influencing the clinical efficacy of the two groups were compared and analyzed.Data were counted using SPSS 25.0,and measures were expressed as cases(n)and analyzed by the Kolmogorov-Smirnov test(Kolmogorov-Smirnov)method,with the mean ± standard deviation(x±s)expressed and the chi-square test or t-test if the data conformed to a normal distribution,and median(interquartile spacing)if they conformed to a non-normal distribution[M(IQR)],expressed by the Mann-Whitney(Mann-Whitney U)method of analysis.The χ2 test(or Fisher’s exact test)was used for comparison between groups,and the nonparametric rank-sum test was chosen for rank data.P<0.05 was considered a statistically significant difference.Results1.The cure rate of 75 cases in the study group was 90.70%,and the total efficacy was 97.40%.The cure rate of 75 patients in the control group was 50.7%,and the total efficacy was 72.00%.Thet otal efficacy of the study group was much higher than that of the control group,and these difference was statistically valuable,P<0.01.2.The recurrence rate of the study group was 5.90%;the recurrence rate of the control group was 34.2%,and recurrence rate was much higher in the control group than in the study group,and the difference was statistically valuable,P<0.01;3.The rate of adverse reactions in the study group was 8.00%;the rate of adverse reactions in the control group was 28.00%.The adverse reactions rate of the study was lower than that of the control group,and the difference was statistically valuable,P<0.05.During the treatment period,pain scores NRPS were not significantly different between the study and control groups,p>0.054.The patients’ gender,age,disease duration,number and size of warts,and lesion site were not related to the recurrence of perianal and anal canal warts,and the differences were not statistically valuable,P>0.05.The type of HPV infection had an effect on the recurrence of perianal and anal canal warts,and the differences were statistically valuable,P<0.05.Conclusion In the study group,the combination of photodynamic therapy with 5aminolevulinic acid and CO2 laser resulted in a significant improvement in the clinical cure rate,a decrease in the recurrence rate of condyloma of the anus and anal canal,a significant decrease in treatment-induced side effects,and improved patient quality of life,compared to the control group. |
