摘要
目的探讨视频辅助肛瘘治疗术(VAAFT)和括约肌间瘘管结扎术(LIFT)治疗复杂性肛瘘的临床疗效。方法选取我院2017年8月至2020年1月收治的202例复杂性肛瘘患者作为研究对象,以随机数字表法分为VAAFT组(n=98,实施VAAFT术)和LIFT组(n=104,实施LIFT术)。观察记录两组手术相关指标(手术时间、术中出血量和住院时间)、创面相关指标(创面面积、创面愈合时间和创面疼痛程度)、疗效、肛门功能、并发症和复发情况。结果两组术中出血量、创面面积、创面愈合时间、术后第1天的VAS疼痛评分比较差异均无统计学意义(均P>0.05);VAAFT组的手术时间长于LIFT组,住院时间短于LIFT组,VAAFT组术后第3、5、7天的VAS疼痛评分低于LIFT组,差异均有统计学意义(均P<0.05)。两组总有效率比较差异无统计学意义(P>0.05);VAAFT组的疗效优于LIFT组(P<0.05)。术后第7天,VAAFT组的Wexner肛门失禁评分低于LIFT组(P<0.05)。两组并发症发生率和复发率比较差异均无统计学意义(均P>0.05)。结论VAAFT术与LIFT术治疗复杂性肛瘘均可取得较为满意的临床效果。与LIFT术相比,VAAFT术可缩短住院时间,减轻术后第3、5、7天的疼痛程度,对术后的肛门功能影响更小,治疗效果更优。
Objectives To investigate the clinical effectiveness of video-assisted anal fistula treatment(VAAFT)and ligation of intersphincteric fistula tract(LIFT)for complex anal fistula.Methods Two hundred and two patients with complex anal fistula treated at our hospital between August 2017 and January 2020 were recruited and randomly assigned to the VAAFT group(n=98,receiving VAAFT)and LIFT group(n=104,receiving LIFT)by using random number table.The followings were recorded in both groups:surgical parameters(operative time,blood loss,and duration of hospitalization),parameters of wound healing(wound area,healing time,and pain),effectiveness,anal function,the incidence of complications and recurrence.Results The two groups were comparable in terms of blood loss,wound area,healing time,and pain visual analog scale(VAS)score at 1 day af⁃ter surgery(P>0.05).Compared with the LIFT group,the VAAFT group had significantly longer operative time,shorter duration of hospitalization,and lower pain VAS scores at 3,5,and 7 days after surgery(P<0.05).The overall effectiveness(the propor⁃tion of patients in whom the treatment was categorized as cured,markedly effective,or effective)was comparable between the two groups(P>0.05).VAAFT group had better effectiveness than LIFT group(P<0.05).The Wexner score for anal incontinence at 7 days after surgery was significantly lower in the VAAFT group than in the LIFT group(P<0.05).The incidence of complica⁃tions and recurrence were not significantly different between the two groups(P>0.05).Conclusion Both VAAFT and LIFT can achieve satisfactory results for complex anal fistula.Compared to LIFT,VAAFT is associated with shorter duration of hospitaliza⁃tion,less pain at 3,5,and 7 days after surgery,less impact on postoperative anal function,and better effectiveness.
作者
李淑菊
田颖
冯俊伟
薛瑶涵
Li Shuju;Tian Ying;Feng Junwei;Xue Yaohan(Department of Anorectal Surgery,Beijing Anorectal Hospital,Beijing 100120,China)
出处
《结直肠肛门外科》
2021年第4期383-386,共4页
Journal of Colorectal & Anal Surgery
基金
首都临床特色应用研究与成果推广课题(Z171100001017100)。
关键词
复杂性肛瘘
视频辅助肛瘘治疗术
括约肌间瘘管结扎术
complex anal fistula
video-assisted anal fistula treatment
ligation of intersphincteric fistula tract
