Seton 引流联合纤维蛋白胶注射治疗复杂性肛瘘。

Seton drainage and fibrin glue injection for complex anal fistulas.

机构信息

Proctologie médico-interventionnelle Groupe hospitalier Diaconesses - Croix Saint Simon, rue du Sergent Bauchat, Paris, France.

出版信息

Colorectal Dis. 2010 May;12(5):459-63. doi: 10.1111/j.1463-1318.2009.01811.x. Epub 2009 Feb 7.

DOI:10.1111/j.1463-1318.2009.01811.x

PMID:19210300

Abstract

OBJECTIVE

The study aimed to evaluate the efficacy of fibrin glue in the treatment of complex anal fistula.

METHOD

Thirty consecutive patients with a complex anal fistula underwent glue instillation after an 8 week period of seton drainage. Cure was defined as complete closure of any secondary opening, absence of fistula seepage, and no abscess formation.

RESULTS

The mean age of the patients (15 males) was 40.5 (range, 22.8-69.1) years. The mean duration of follow-up was 11.7 (range, 0.2-33.5) months. Complete closure of the fistula was achieved in 17 patients at 1 month but in two patients a delayed abscess occurred. At the end of follow-up, 15 (50%) patients were considered to have been cured. The success rate was no different in cases of Crohn's disease or when postoperative antibiotic therapy was given. There was, however, a significant difference in success following regional vs general anaesthesia (68.4 vs 18.2% success, P = 0.02).

CONCLUSION

Fibrin glue cured 50% of our first 30 patients, and regional anaesthesia was predictive of success.

摘要

目的

本研究旨在评估纤维蛋白胶治疗复杂性肛痿的疗效。

方法

30 例复杂性肛痿患者在接受 8 周橡皮带挂线引流后行胶滴注治疗。治愈定义为所有 secondary opening 完全闭合，无痿管渗漏，无脓肿形成。

结果

患者（15 名男性）的平均年龄为 40.5 岁（范围，22.8-69.1 岁）。平均随访时间为 11.7 个月（范围，0.2-33.5 个月）。17 例患者在 1 个月时瘘管完全闭合，但 2 例患者出现迟发性脓肿。随访结束时，15 例（50%）患者被认为治愈。在克罗恩病患者或术后给予抗生素治疗的情况下，成功率没有差异。然而，区域麻醉与全身麻醉的成功率有显著差异（68.4%与 18.2%的成功率，P=0.02）。