Chen Yan, Wang Xiaofeng, Jin Heiying, Zhang Bei, Yao Hang, Wu Kunlan, Wang Shuiming
National Center of Colorectal Surgery, The Third affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210001, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Apr;19(4):442-5.
To explore the feasibility of three-cavity clearance (TCC) in the treatment of perianal abscess.
A retrospective study of patients with perianal abscess in our center from July 2013 to March 2015 were carried out. Clinical data of 25 patients undergoing TCC (TCC group) were analyzed. At the same time, based on matched gender, age and location of abscess, 25 patients undergoing incision and drainage (incision group) and 25 undergoing cutting seton (seton group) were enrolled. Postoperative pain visual analogue scale (VAS) score (the first defecation,1 week later), rate of fistula formation, fecal incontinence(Wexner score) and wound healing were compared among groups.
One week after operation, VAS score in seton group was 6.5±1.3, which was significantly higher than 1.3±0.5 in TCC group and 1.2±0.4 in incision group(P<0.01), while there were no significant differences of VAS among groups at the first defecation(P>0.05). Time of wound healing was (45.8±19.9), (49.2±23.1) and (53.5±24.1) days in TCC, incision and seton group respectively, without significant difference(P>0.05). Rate of fistula formation was 48.0% (12/25) in incision group, which was significantly higher than 12.0% (3/25) in TCC group and 12.0%(3/25) in seton group (all P<0.01). There was no patient with faecal incontinence in TCC group and incision group, while 2 patients with fecal incontinence were found in seton group.
Three-cavity clearance is feasible in treatment of perianal abscess, and can decrease the rate of fistula formation, ameliorate postoperative pain and protect anal function.
探讨三腔间隙清除术（TCC）治疗肛周脓肿的可行性。
对2013年7月至2015年3月在本中心接受治疗的肛周脓肿患者进行回顾性研究。分析25例行TCC治疗的患者（TCC组）的临床资料。同时，根据性别、年龄和脓肿部位匹配，纳入25例行切开引流术的患者（切开组）和25例行挂线术的患者（挂线组）。比较各组术后疼痛视觉模拟评分（VAS）（首次排便时、术后1周）、肛瘘形成率、大便失禁（Wexner评分）及伤口愈合情况。
术后1周，挂线组VAS评分为6.5±1.3，显著高于TCC组的1.3±0.5和切开组的1.2±0.4（P<0.01），而首次排便时各组VAS评分差异无统计学意义（P>0.05）。TCC组、切开组和挂线组伤口愈合时间分别为（45.8±19.9）、（49.2±23.1）和（53.5±24.1）天，差异无统计学意义（P>0.05）。切开组肛瘘形成率为48.0%（12/25），显著高于TCC组的12.0%（3/25）和挂线组的12.0%（3/25）（均P<0.01）。TCC组和切开组均无大便失禁患者，挂线组有2例大便失禁患者。
三腔间隙清除术治疗肛周脓肿可行，可降低肛瘘形成率，减轻术后疼痛，保护肛门功能。
