De Parades Vincent, Haouari Mohamed Amine, Fathallah Nadia, Spindler Lucas, Barré Amélie, Pommaret Elise, Benfredj Paul
Service de proctologie médico-chirurgicale, groupe hospitalier Paris Saint-Joseph, Paris, France.
Service de radiologie,groupe hospitalier Paris Saint-Joseph, Paris, France.
Rev Prat. 2023 Mar;73(3):274-278.
SPARING THE SPHINCTER. Fistulotomy is the most used treatment for anal fistula. It is very effective with a cure rate of over 95% but carries a risk of incontinence. This has led to the development of various sphincter sparing techniques. The injection of biological glue or paste and the insertion of a plug have disappointing results and are expensive. The rectal advancement flap is still practised because of its cure rate of around 75% but it may result in some incontinence. Intersphincteric ligation of the fistula track and laser treatment are widely practised in France with cure rates between 60 and 70%. Video-assisted anal fistula treatment as well as injections of adipose tissue, stromal vascular fraction, platelet-enriched plasma and/or mesenchymal stem cells are emerging techniques for which even better results are expected.
保留括约肌。肛瘘切开术是治疗肛瘘最常用的方法。它非常有效，治愈率超过95%，但有失禁风险。这促使了各种保留括约肌技术的发展。注射生物胶水或糊剂以及插入塞子效果不佳且费用高昂。直肠推进皮瓣术仍在应用，因其治愈率约为75%，但可能导致一些失禁。瘘管间括约肌结扎术和激光治疗在法国广泛应用，治愈率在60%至70%之间。视频辅助肛瘘治疗以及注射脂肪组织、基质血管成分、富血小板血浆和/或间充质干细胞是新兴技术，预计会有更好的效果。
