Observation on the changes of anal function in the treatment of transjottic anal fistula by LIFT technique and anal fistula incision

Abstract

Objective To observe the effect of LIFT surgery and anal fistula incision on the metastatic anal fistula in the near-long anal function. Methods A total of 120 patients with sphincter anal fistula treated in our hospital from September 2015 to February 2017 were randomly divided into observation group and control group, sixty cases in each group. The control group was treated with anal fistula incision, the observation group was treated with LIFT surgery. The operation time, wound healing time, the VAS pain score at 1 d, 3 d and 7 d after operation, the total cure rate, the total incidence of postoperative complications of 1 month after operation, the recurrence rate of followed up six months, the anal function (evaluated by pelvic floor electromyography and anal rectal pressure) of before operation and 1 month and 6 months after operation were compared between the two groups. Results The wound healing time of the observation group was (27.44±6.12) d, which shorter than (32.71±8.35) d in the control group (t=-3.943, P=0.000). There were no significant difference in VAS pain scores between the two groups at 1 d and 3 d after operation (P>0.05). The VAS pain score of the observation group was (2.11±0.66) at the 7 th day after operation, which was lower than that of the control group (3.56±0.91) (t=-9.991, P=0.000). The healing rates of the observation group and the control group were 90.00% and 93.33%, and the recurrence rates were 13.33% and 10.00%, the difference were not significant (P>0.05). The total incidence of postoperative complications was 3.33% in the observation group, which was lower than 13.33% in control group (χ2=3.927, P=0.048). There was no significant difference between the mean time limit of MUP in the puborectal muscles, internal sphincter and external sphincter, anal canal resting pressure and anal canal maximum systolic blood pressure of 1 month and 6 months after operation were no statistically significant compared to preoperative in observation group (P>0.05), and were decreased in the control group (P<0.05). The mean time limit of MUP in the puborectal muscles, internal sphincter and external sphincter, anal canal resting pressure and anal canal maximum systolic blood pressure of 1 month and 6 months after operation in observation group were higher than those in control group. Conclusion The LIFT treatment of the sphincter anal fistula can reduce the operation of the sphincter injury, thereby reducing the patient′s postoperative pain, promote wound healing, reduce postoperative complications, so that patients with near-term anal function was protected. Key words: Transthoracic fistula; Anal fistula incision; Ligation of the intersphinctericfistula tract; Anal function