经肛括约肌间切开术在治疗复杂性肛瘘中的应用-现代医学

经肛括约肌间切开术在治疗复杂性肛瘘中的应用

单位：东南大学附属中大医院江北院区(南京市大厂医院) 肛肠科, 江苏南京 210048

分类号：R266

出版年·卷·期（页码）：2022·50·第五期（588-591）

摘要：

目的：评价经肛括约肌间切开术治疗复杂性肛瘘的临床疗效。方法：分析2019年8月1日至2020年8月31日期间在东南大学附属中大医院肛肠科行经肛括约肌间切开手术的27例肛瘘患者的临床资料。结果：随访6~18个月，平均（10.19±3.78）个月。男24例，女3例，年龄21~73岁，平均（41.96±12.28）岁。瘘管治愈率85.19%（23/27），14.81%（4/27）未愈。Wexner肛门失禁评分手术前后相比较，差异无统计学意义（P>0.05）。术后出血1例、尿潴留3例，未发生其他严重并发症。结论：经肛括约肌间切开术是一种简单有效的保留括约肌手术，可用于治疗包括提肛肌上方和马蹄型肛瘘在内的复杂性肛瘘。

Objective:To evaluate the efficacy of transanal opening of intersphincteric space(TROPIS) for the treatment of complex anal fistula. Methods:The clinical data of 27 patients with anal fistula who underwent anal sphincterotomy in the Anorectal Department of Zhongda Hospital Affiliated to Southeast University from August 1, 2019 to August 31, 2020 were analyzed. Results:The follow-up period was 6-18 months, with an average of(10.19±3.78) months. There were 24 males and 3 females, aged 21-73 years, with an average of(41.96±12.28) years. The curative rate of fistula was 85.19%(23/27), and 14.81%(4/27) had not been cured. Wexner anal incontinence score showed no significantly statistical difference before and after operation(P>0.05). Postoperative bleeding occurred in 1 case, urinary retention in 3 cases, and no other serious complications were found. Conclusion:TROPIS is a simple and effective sphincter sparing procedure to treat high complex anal fistula, including supralevator and horseshoe fistula.

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