Zhang Yuru, Li Fei, Zhao Tuanjie, Cao Feng, Zheng Yamin, Li Ang
Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Colorectal Surgery, Beijing Erlonglu Hospital, Beijing, China.
Ann Transl Med. 2020 Nov;8(22):1517. doi: 10.21037/atm-20-7154.
To explore the efficacy of video-assisted anal fistula treatment (VAAFT) combined with an internal-opening closure technique using a stapler in the treatment of Parks II anal fistula.
From September 2017 to June 2019, 75 patients with Parks II anal fistulas in Beijing Erlonglu Hospital were enrolled and randomly allocated into two groups. The 37 patients in the treatment group received VAAFT combined with internal-opening closure techniques, and the 38 patients in the control group were treated with anal fistulotomy with seton placement. The primary outcomes included the healing rate and recurrence, the fecal incontinence severity index (FISI) score, and the Wexner incontinence score during the 6-month postoperative follow-up.
Thirty-two cases were healed in the treatment group (86.5%) and thirty-six cases were cured in the control group (94.7%). There was no notable difference in the healing rate between the two groups (P=0.487). Significant differences between the groups were observed in the Wexner incontinence and FISI scores at 1, 3, and 6 months after the operation (P=0.001). Furthermore, the wound healing time in the treatment group was significantly shorter than in the control group (P<0.05), while the numerical rating scale (NRS) for postoperative pain on the first day and 1 week after the operation were significantly lower in the treatment group than in the control group (P<0.05).
VAAFT combined with closure of the internal opening using a stapler is effective and safe for Parks II anal fistula, and should be promoted as a promising treatment.
探讨视频辅助肛瘘治疗（VAAFT）联合使用吻合器闭合内口技术治疗帕克Ⅱ型肛瘘的疗效。
2017年9月至2019年6月，北京二龙路医院75例帕克Ⅱ型肛瘘患者被纳入研究并随机分为两组。治疗组37例患者接受VAAFT联合内口闭合技术，对照组38例患者接受挂线疗法肛瘘切开术。主要观察指标包括术后6个月随访期间的愈合率、复发率、大便失禁严重程度指数（FISI）评分和韦克斯纳失禁评分。
治疗组32例愈合（86.5%），对照组36例治愈（94.7%）。两组愈合率差异无统计学意义（P = 0.487）。术后1、3和6个月时，两组在韦克斯纳失禁评分和FISI评分方面存在显著差异（P = 0.001）。此外，治疗组伤口愈合时间明显短于对照组（P < 0.05），且治疗组术后第1天和术后1周的术后疼痛数字评定量表（NRS）明显低于对照组（P < 0.05）。
VAAFT联合使用吻合器闭合内口治疗帕克Ⅱ型肛瘘有效且安全，应作为一种有前景的治疗方法推广。
