摘要
Abstract
Objective To explore the clinical efficacy of transanal opening of intersphincteric space(Tro-pis)combined with modified Hanley procedure in the treatment of high posterior horseshoe-shaped anal fistula.Methods From January 2023 to February 2024,total 45 patients with posterior horseshoe-shaped anal fistula treated in our hospital were randomly divided into a combined group,a thread-drawing group and an anal fistula plug group,with 15 cases in each group.The combined group was treated with Tropis combined with modified Hanley procedure,the thread-drawing group was treated with solid thread-ligating therapy for anal fistula,and the anal fistula plug group was treated with anal fistula plug occlu-sion.The efficacy,anal function,myoglobin levels and postoperative complications of the three groups were compared.Results The postoperative pain score of the combined group was significantly lower than that of the thread-drawing group(P＜0.05),and the VAS score of the combined group was similar to that of the anal fistula plug group 3-7 days after surgery(P＞0.05).The postoperative Wexner score of the combined group was lower than that of the anal fistula plug group(P＜0.05),but significantly better than that of the thread-drawing group(P＜0.05).The serum myoglobin levels of the combined group and the anal fistula plug group were within the normal range 3 days,7 days and 11 days after sur-gery,and were significantly lower than those of the thread-drawing group(P＜0.05).Six months after surgery,the anal canal resting pressure and maximum systolic pressure of the combined group were signif-icantly better than those of the thread-drawing group(P＜0.05),and there was no significant difference compared with the anal fistula plug group(P＞0.05).After half a year of follow-up,11 cases in the com-bined group were cured,with a cure rate of 86.7％.Conclusion Tropis combined with modified Hanley procedure has a significant effect in the treatment of high posterior horseshoe-shaped anal fistula.It can protect the anal function and external sphincter complex to the greatest extent,and has a high cure rate,which is worthy of clinical promotion and application.关键词
高位后蹄铁型肛瘘/Tropis术/改良Hanley术/疗效Key words
High posterior horseshoe-shaped anal fistula/Tropis procedure/Modified Hanley proce-dure/Efficacy
