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用于肛瘘闭合的OTSC®直肠学夹系统:首批前瞻性临床数据。

The OTSC® Proctology clip system for anal fistula closure: first prospective clinical data.

作者信息

Prosst Ruediger L, Ehni Wolfgang, Joos Andreas K

机构信息

Proctological Institute Stuttgart , Stuttgart , Germany.

出版信息

Minim Invasive Ther Allied Technol. 2013 Sep;22(5):255-9. doi: 10.3109/13645706.2013.826675. Epub 2013 Aug 25.

Abstract

INTRODUCTION

Anorectal fistulas represent a troublesome condition for both patient and surgeon. The OTSC® Proctology clip system is a new device for transanal anorectal fistula closure.

MATERIAL AND METHODS

The OTSC® Proctology system was evaluated in a prospective clinical study undertaken in two surgical proctological centers. Ten patients (three women, seven men; median age 55 years, range 25-73 years) with nine transsphincteric and one suprasphincteric fistulas were enrolled into the study.

RESULTS

The median operation time was 30 minutes (range 20-45 minutes). There were no intraoperative technical or surgical complications. Postoperatively, no patient reported intolerable discomfort, immoderate pain or foreign body sensation in the anal region. At follow-up examination six months after surgery, nine out of ten patients had no clinical signs or symptoms of their previous fistula and were considered as healed (success rate 90%). In one patient persistency of the fistula was noted due to spontaneous early clip detachment on the third postoperative day.

DISCUSSION

These first data demonstrate the efficacy of the OTSC® Proctology system in the treatment of anal fistulas. Currently, more patients were enrolled into this prospective study to allow further evaluation of this new device and to assess its future role in relation to established surgical strategies for anorectal fistulas.

摘要

引言

肛瘘对患者和外科医生来说都是一个棘手的病症。OTSC® 直肠学夹系统是一种用于经肛门闭合肛瘘的新装置。

材料与方法

在两个直肠外科中心进行的一项前瞻性临床研究中对OTSC® 直肠学系统进行了评估。十名患者(三名女性,七名男性;年龄中位数55岁,范围25 - 73岁),其中九例为经括约肌肛瘘,一例为括约肌上肛瘘,被纳入该研究。

结果

手术时间中位数为30分钟(范围20 - 45分钟)。术中无技术或手术并发症。术后,没有患者报告肛门区域有无法忍受的不适、剧烈疼痛或异物感。在术后六个月的随访检查中,十名患者中有九名没有先前肛瘘的临床体征或症状,被认为已治愈(成功率90%)。一名患者因术后第三天夹子自发早期脱落而出现肛瘘持续存在的情况。

讨论

这些初步数据证明了OTSC® 直肠学系统在治疗肛瘘方面的有效性。目前,更多患者已被纳入这项前瞻性研究中,以便对这种新装置进行进一步评估,并评估其相对于既定的肛瘘手术策略的未来作用。

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