改良括约肌间瘘管结扎术的结果
Results from a novel modification to the ligation intersphincteric fistula tract.
作者信息
Bastawrous Amir, Hawkins Melinda, Kratz Rodney, Menon Raman, Pollock Darren, Charbel Jacquelyn, Long Kevin
机构信息
Swedish Colon and Rectal Clinic, Swedish Medical Center, 1101 Madison, Seattle, WA 98410, USA.
Swedish Colon and Rectal Clinic, Swedish Medical Center, 1101 Madison, Seattle, WA 98410, USA.
出版信息
Am J Surg. 2015 May;209(5):793-8; discussion 798. doi: 10.1016/j.amjsurg.2015.01.002. Epub 2015 Feb 16.
BACKGROUND
The ligation of intersphincteric fistula tract (LIFT) procedure for trans-sphincteric fistula-in-ano has been studied with variable success rates compared with initial reports. Failures occur mostly in the intersphincteric wound. Recently, we proposed a modification to LIFT, unroofing the fistula from internal opening to intersphincteric groove, ligating the fistula tract, but preserving the external sphincter.
METHODS
This retrospective review assesses outcomes of patients undergoing the modified LIFT for trans-sphincteric fistulae.
RESULTS
Sixty-six modified LIFT procedures were performed. The main cohort consisted of 56 patients, predominantly men (76.7%). Median operative time was 16 minutes. Median follow-up was 20.98 weeks. Overall cure rate was 71.42%, with a recurrence rate of 5.35% and fistula persistence in 16.07%. There was no persistent fecal incontinence.
CONCLUSION
Modified LIFT is a safe procedure that is easily performed, has short operative time, eliminates the intersphincteric space, and has cure rates equal to or better than the original LIFT.
背景
与最初的报道相比，经括约肌间瘘管结扎术（LIFT）治疗经括约肌肛瘘的成功率有所不同。失败大多发生在括约肌间伤口。最近，我们提出了一种对LIFT的改良方法，即从内口到括约肌间沟切开瘘管，结扎瘘管，但保留外括约肌。
方法
这项回顾性研究评估了接受改良LIFT治疗经括约肌肛瘘患者的治疗结果。
结果
共进行了66例改良LIFT手术。主要队列包括56例患者，以男性为主（76.7%）。中位手术时间为16分钟。中位随访时间为20.98周。总体治愈率为71.42%，复发率为5.35%，瘘管持续存在率为16.07%。无持续性大便失禁。
结论
改良LIFT是一种安全的手术方法，操作简便，手术时间短，消除了括约肌间间隙，治愈率等于或优于原LIFT。
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