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基于FLUENT流体动力学模拟的高位复杂性肛瘘不同切口引流效果分析

Analysis of the drainage effect of different incisions for high complex anal fistula based on FLUENT hydrodynamic simulation.

作者信息

Zhang Jiamin, Li Xiang, Ma Jiaze, Chen Peng, Li Wanli, Hu Junjie, Li Xiaoliu, Chen Yile, Ding Kang

机构信息

Nanjing University of Chinese Medicine, Graduate School of Nanjing University of Chinese Medicine, Nanjing, China.

Colorectal Disease Center of Nanjing Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Front Surg. 2022 Aug 12;9:974341. doi: 10.3389/fsurg.2022.974341. eCollection 2022.

DOI:10.3389/fsurg.2022.974341
PMID:36034382
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9412015/
Abstract

PURPOSE

The biomechanical characteristics of the trauma size and postoperative drainage of different incisions for high complex anal fistula surgery were compared by numerical simulation analysis to provide a theoretical basis for the clinical selection of minimally invasive incisions for surgery.

METHODS

Using FLUENT finite element software, a typical incision finite element model was established to obtain incision areas, and the total mass outlet flow within 200 s was calculated to evaluate the drainage effect of each incision.

RESULTS

The incisions with the largest to smallest areas were the curved, spindle, and curved plus extended groove incision, indicating that the curved plus extended groove incision caused the least damage to the perianal skin muscles. Conversely, the incisions with the largest to smallest total outlet flow were as follows: curved plus extended groove, spindle, curved, and straight incision, suggesting that the curved plus extended groove model had the best diversion effect, and the curved incision had better diversion effect than that of the straight incision.

CONCLUSION

The curved plus extended groove surgical incision had the smallest incision area, minimized damage to the perianal skin and muscle tissue, conformed to the concept of minimally invasive surgery, ensured adequate drainage of exudate, maintained the normal growth of granulation tissue on the wound surface, preserved the original form of the anus, and thus better protected the function of the anus. This improved the quality of life of patients requiring high complex anal fistulas.

摘要

目的

通过数值模拟分析比较高位复杂性肛瘘手术不同切口的创伤大小及术后引流的生物力学特性，为临床选择微创手术切口提供理论依据。

方法

利用FLUENT有限元软件建立典型切口有限元模型，获取切口面积，并计算200 s内的总质量出口流量，以评估各切口的引流效果。

结果

面积由大到小的切口依次为弧形、梭形、弧形加延长槽切口，表明弧形加延长槽切口对肛周皮肤肌肉的损伤最小。相反，总出口流量由大到小的切口依次为：弧形加延长槽、梭形、弧形、直切口，提示弧形加延长槽模型的引流效果最佳，弧形切口的引流效果优于直切口。

结论

弧形加延长槽手术切口面积最小，对肛周皮肤和肌肉组织的损伤最小，符合微创手术理念，保证了渗出物的充分引流，维持了创面肉芽组织的正常生长，保留了肛门的原始形态，从而更好地保护了肛门功能。这提高了高位复杂性肛瘘患者的生活质量。

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