部分瘘管切开术与改良切割挂线术治疗高位外括约肌外肛管直肠瘘
Partial fistulotomy and modified cutting seton procedure in the treatment of high extrasphincteric perianal fistulae.
作者信息
Durgun Vedat, Perek Asiye, Kapan Metin, Kapan Selin, Perek Sadi
机构信息
Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
出版信息
Dig Surg. 2002;19(1):56-8. doi: 10.1159/000052007.
AIM
In our prospective study the method of partial distal fistulotomy and modified cutting seton for high extrasphincteric perianal fistulae is discussed.
METHODS
10 patients (9 males and 1 female) with high extrasphincteric perianal fistulae were treated with partial distal fistulotomy and modified cutting seton. Four or five threads were introduced through the tract; one was tied tightly at the end of the operation, others were tightened every 10th day. While the tied thread cut the tissue, the others drained the tract. The follow-up period ranged from 3 months to 9 years.
RESULTS
None of the patients developed major fecal incontinence. 2 of the 10 patients complained of incontinence due to flatus.
CONCLUSION
Distal fistulotomy and modified cutting seton can be used in perianal fistulae with high anal or rectal opening, because it combines the effects of both cutting and loose setons and because the postoperative results regarding continence are satisfactory.
目的
在我们的前瞻性研究中，探讨了部分远端瘘管切开术联合改良切割挂线疗法治疗高位括约肌外肛管直肠瘘的方法。
方法
10例高位括约肌外肛管直肠瘘患者（9例男性，1例女性）接受了部分远端瘘管切开术联合改良切割挂线治疗。通过瘘管置入4或5根丝线；1根在手术结束时扎紧，其他丝线每隔10天收紧一次。扎紧的丝线切割组织，其他丝线引流瘘管。随访时间为3个月至9年。
结果
所有患者均未出现严重大便失禁。10例患者中有2例抱怨因排气出现失禁。
结论
远端瘘管切开术联合改良切割挂线可用于肛管或直肠开口较高的肛瘘，因为它结合了切割挂线和松挂线的效果，且术后控便结果令人满意。
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