Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula.

Xiao Wang,Chunliang Wang,Ruihua Qi

doi:10.1155/2021/6940072

Xiao Wang, Chunliang Wang + Show 1 more

Open Access

https://doi.org/10.1155/2021/6940072

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Abstract

Objective This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone. Methods 125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only. Results The VAS scores of the trauma in the OG were lower than those in the CG on 1st day of surgery and 7 days after surgery (P < 0.05). The length of hospital stay and time to wound healing were shorter in the OG than in the CG (P < 0.05). The incidence of postoperative bleeding in the OG was 9.52%, which was lower than 22.58% in the CG (P < 0.05). The rectal examination scores were lower in the OG than in the CG at 3 and 5 days postoperatively (P < 0.05). The Wexner scores of solid incontinence (0 to 4), liquid incontinence (0 to 4), gas incontinence (0 to 4), pad wearing (0 to 4), and lifestyle alteration (0 to 4) in the OG were lower than those of the CG at 5 days postoperatively (P < 0.05). Voiding function scores were lower in the OG than in the CG at 2 and 3 days postoperatively (P < 0.05). Conclusions The efficacy of drainage skin-bridge sparing surgery combined fistulotomy is better than that of fistulotomy alone, which can accelerate postoperative healing, enhance urinary function, reduce postoperative bleeding, and improve anal function.

Highlights

Anal fistula (AF) is a chronic abnormal communication between the epithelialized surface of the anal canal and usually the perianal skin
AF was mostly treated by fistula removal, which was effective in removing the fistula, but due to the long incision, a significant scar was left after surgery and the patient will experience a long recovery period [6]
Visual Analogue Scale (VAS) scores for trauma pain were significantly lower in the Observation Group (OG) than in the Control Group (CG) upon surgery (P < 0.05), and VAS scores decreased significantly in both groups on postoperative days 3, 5, and 7 compared with the postoperative day (P < 0.05), but the difference between groups on postoperative days 3 and 5 was not statistically significant (P > 0.05), and VAS scores were significantly lower in the OG than in the CG at 7 days postoperatively (P < 0.05) (Figure 1)

Summary

Introduction

Anal fistula (AF) is a chronic abnormal communication between the epithelialized surface of the anal canal and usually the perianal skin. It can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus [1, 2]. AF could lead to recurrent episode of infection, so that a simple fistula can progress to a complex fistula [4]. AF was mostly treated by fistula removal, which was effective in removing the fistula, but due to the long incision, a significant scar was left after surgery and the patient will experience a long recovery period [6]

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Results

Conclusion