Modified ligation of the intersphincteric fistula tract in the treatment of simple transsphincteric perianal fistula
10.3760/cma.j.issn.1671-0274.2014.12.010
- VernacularTitle:改良经括约肌间瘘管结扎术治疗单纯性经括约肌型肛瘘的临床疗效
- Author:
Wenjing WU
1
;
Guangen YANG
;
Zhongju DU
;
Xiufeng ZHANG
;
Yihuan SONG
;
Jianming QIU
;
Xiujun LIAO
;
Zhong SHEN
Author Information
1. 310009,安徽医科大学杭州临床学院 杭州市第三人民医院 肛肠科
- Keywords:
Fistula transsphincteric simple;
Ligation of the intersphinctericfistula tract;
Efficacy
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(12):1194-1197
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract for simple transsphincteric perianal fistula. Methods Seventy patients with simple transsphincteric perianal fistula between October 2012 and January 2014 in our department were prospectively enrolled. According to the random number table , patients were divided into two groups:modified-LIFT group (37 cases, from the external opening close to the fistula, dissect the external sphincter fistula to the intersphincteric groove by tunneling technique, resect the lateral free fistula) and LIFT group (33 cases). Clinical parametres before and after operation were compared, and results of pelvic electromyogram (EMG) and anorectal manometry three months after operation were analyzed to evaluated anal function. Results The operative time, pain score, hospital stay, and healing time were not significantly different between the two groups (all P>0.05). During the median follow-up of 12 months ( 3-20 months ) , the healing rate in modified-LIFT group was 83 . 8%( 31/37 ) , which was significantly higher than 60%(20/33) in LIFT group (P=0.029). After operation, 4 patients had persistent unhealed wound, 2 recurred in modified-LIFT group, while 8 patients had persistent unhealed wound, and 5 recurred in LIFT group. No patients developed anal incontinence. By the pelvic EMG and anorectal manometry 3 months after operation, the duration of motor unit potential, occurrence of simple phase, mean resting pressure and maximun squeeze pressure were not significantly different. Conclusion Modified-LIFT procedure for the management of simple transsphincteric perianal fistulas is a simple and effective operation with higher healing rate and similar anal function as LIFT.
