RÓs Adriana de Souza, Santos Carlos Henrique Marques Dos, Dourado Doroty Mesquita, Silva-Neto Moisés Soares da, Caldeira Isabela, Furtado Leandro de Oliveira
Colon and Rectum Department, Universitary Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
Anhanguera-Uniderp University, Campo Grande, MS, Brazil.
Arq Bras Cir Dig. 2020 Dec 18;33(3):e1540. doi: 10.1590/0102-672020200003e1540. eCollection 2020.
There is still a need for progress in the treatment of transsphincteric anal fistulae and the use of herbal medicines seems promising.
To evaluate the efficacy of Stryphnodendron adstringens associated with fistulotomy and primary sphincteroplasty in the treatment of transsphincteric fistulae in rats.
Thirty Wistar rats were used, which were submitted to transsphincteric fistulas with steel wire 0; after 30 days a treatment was performed according to the group. Group A (n=10) was submitted to fistulotomy; group B (n=10), fistulotomy followed by primary sphincteroplasty with "U" stitch with polyglactin 911 4-0; group C(n=10) , similar to group B, but with the interposition between the muscular stumps of hemostatic sponge soaked in Stryphnodendron adstringens extract. Euthanasia was performed after 14 days, resecting a segment of the anal canal for histological analysis, which aimed to evaluate the closure of the fistula, the area of separation of the muscle cables, the inflammatory process and the degree of fibrosis.
No animal had a remaining fistulous tract. About the spacing between the muscle cables, an average of 106.3 µm2 was observed in group A, 82.8 µm2 in group B and 51.8 µm2 in group C (p<0.05). There was no difference between the groups regarding the inflammatory process and, in relation to fibrosis, in group A there was a mean of 0.6, in group B 0.7 and in group C 0.2 (p<0.05).
Stryphnodendron adstringens extract was able to allow less spacing between muscle cables in rats submitted to fistulotomy followed by primary sphincteroplasty, in addition to providing less local fibrosis.
经括约肌肛瘘的治疗仍需取得进展，而草药的应用似乎前景广阔。
评估收敛含羞草与瘘管切开术及一期括约肌成形术联合应用于大鼠经括约肌肛瘘治疗的疗效。
选用30只Wistar大鼠，用0号钢丝造成经括约肌瘘；30天后根据分组进行治疗。A组（n = 10）行瘘管切开术；B组（n = 10），瘘管切开术后用4-0聚乙醇酸911行“U”形缝合进行一期括约肌成形术；C组（n = 10），与B组相似，但在肌肉残端间置入浸有收敛含羞草提取物的止血海绵。14天后实施安乐死，切除一段肛管进行组织学分析，旨在评估瘘管闭合情况、肌束分离面积、炎症过程及纤维化程度。
无动物残留瘘管。关于肌束间距，A组平均为106.3 µm²，B组为82.8 µm²，C组为51.8 µm²（p<0.05）。各组间炎症过程无差异，关于纤维化，A组平均值为0.6，B组为0.7，C组为0.2（p<0.05）。
收敛含羞草提取物能够使接受瘘管切开术及一期括约肌成形术的大鼠肌束间距更小，此外还能减少局部纤维化。
