Ligation of intersphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula: A Meta-analysis
10.3760/cma.j.issn.1673-4203.2017.12.012
- VernacularTitle:括约肌间瘘管结扎术与切开挂线术比较治疗复杂性肛瘘的Meta分析
- Author:
Xiang CUI
1
;
Jie DANG
;
Zhengkui PENG
;
Zhijun MA
;
Xuechao XU
;
Tianlong MA
;
Zhiyun HE
Author Information
1. 兰州大学第二医院结直肠外科
- Keywords:
Rectal fistula;
Randomized controlled trial;
Meta-analysis;
Ligation of intersphincteric fistula tract;
Incision-thread-drawing procedure
- From:
International Journal of Surgery
2017;44(12):837-841,封4
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically investigate the clinical efficiency and safety of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Methods Searched PubMed,The Cochrane Library,CNKI,WanFang Data,and VIP from inception to May 2016,to collect randomized controlled trials of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Search term included ligation of inter sphincteric fistula tract,fistula,incision-thread-drawing procedure,randomized controlled trial.The literatures were screened according to inclusive criteria,data were extracted and the quality of included studies was evaluated,and then meta-analysis was performed using RevMan 5.2 soft ware.A total of 5 randomized controlled trials including 305 patients were included.Results The results of meta-analysis showed that compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract had a significant difference in amount of bleeding during surgery (MD =-18.30,95％ CI:-19.91 ～-16.69,P ＜ 0.000 01),the duration of pain (MD =-4.38,95％ CI:-4.69 ～-4.08,P ＜ 0.000 01),healing time (MD =-10.28,95％ CI:-15.71 ～-4.86,P =0.0002),hospital stay (MD =-7.44,95％CI:-10.87～-4.02,P＜0.000 1),recurrence rate (OR=0.31,95％CI:0.10～0.91,P=0.03).There was no significant difference in Operation time (MD =-5.83,95 ％ CI:-7.64 ～-4.02,P ＜ 0.000 01),effective percentage (OR =4.35,95％ CI:0.89 ～ 21.32,P =0.07) between both groups.Conclusion Compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract shows significant advantage in cure rate,postoperative healing time,reducing post-operation pain,anal function protection and recurrence rate.
