肛周脓肿的治疗和复发及控便功能的长期预后。

Treatment of perianal sepsis and long-term outcome of recurrence and continence.

机构信息

Department of General Surgery, Medical University Vienna, Vienna, Austria.

出版信息

Colorectal Dis. 2011 Jun;13(6):703-7. doi: 10.1111/j.1463-1318.2010.02250.x. Epub 2010 Mar 11.

DOI:10.1111/j.1463-1318.2010.02250.x

PMID:20236152

Abstract

AIM

The study investigated the fate of patients with perianal sepsis of cryptoglandular origin.

METHOD

All patients treated for perianal sepsis between January 1994 and December 2000 were retrospectively analysed regarding recurrence and faecal incontinence. Data collection was conducted by chart review and by telephone questionnaire using the Vaizey incontinence score.

RESULTS

One hundred seventy-three (58%) of 300 patients were available for follow-up at a median period of 121 (77-171) months. Fistula-in-ano was diagnosed in 156 (90%) patients. After a single surgical procedure, 55 (32%) patients had no recurrence of perianal sepsis. In 118 (68%), recurrence required multiple procedures (median 3, range 2-19). If only a single incision and drainage was performed (n = 10, 6%), no faecal incontinence occurred. Drainage with fistulotomy (n = 45, 26%) induced mild incontinence in 9% and severe incontinence in 4%. After multiple procedures that were required in 118 (68%) patients, mild and severe faecal incontinence was found in 16% and 4% of them, respectively.

CONCLUSION

Treatment of anal sepsis is associated with a high recurrence rate and a substantial risk of faecal incontinence.

摘要

目的

本研究旨在探讨肛门会阴区隐匿性感染所致的肛周脓肿患者的转归。

方法

回顾性分析 1994 年 1 月至 2000 年 12 月期间所有接受肛周脓肿治疗的患者的复发和粪便失禁情况。通过病历回顾和使用 Vaizey 失禁评分的电话问卷调查进行数据收集。

结果

300 例患者中，173 例（58%）在中位随访时间 121（77-171）个月时可进行随访。156 例（90%）患者诊断为肛瘘。经过单次手术，55 例（32%）患者肛周脓肿无复发。118 例（68%）患者需要多次手术（中位数 3 次，范围 2-19 次）。如果仅行单一切开引流术（n = 10，6%），则无粪便失禁发生。行瘘管切开术（n = 45，26%）引流术导致轻度失禁占 9%，重度失禁占 4%。在 118 例（68%）患者需要多次手术的情况下，轻度和重度粪便失禁分别见于 16%和 4%的患者。