Goldberg Stanley M, Tozer Philip, Phillips Robin, Buntzen Steen
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Ugeskr Laeger. 2011 Apr 4;173(14):1053-5.
The treatment of transsphincteric anal fistulas is a balance between the elimination of the sepsis and the functional outcome. In the last few decades sphincter preserving methods have been developed. Fibrin glue and the anal fistula plug are methods with excellent functional outcomes, but the success rates have decreased in recent years. The endorectal advancement flap is the gold standard with a high success rate, but with a risk of minor incontinence. The procedure of the ligation of the intersphincteric fistula tract is the latest option with excellent result so far. The tailored treatment with enhanced glues looks promising.
经括约肌肛瘘的治疗是消除脓毒症与功能预后之间的平衡。在过去几十年中，已开发出保留括约肌的方法。纤维蛋白胶和肛瘘栓是功能预后良好的方法，但近年来成功率有所下降。直肠推进皮瓣是成功率高的金标准，但有轻微失禁的风险。括约肌间瘘管结扎术是目前效果极佳的最新选择。使用改良胶水进行的个体化治疗看起来很有前景。
