Ignat'ev V V, Shramko P V, Muraviev A V, Garapov T A, Tishukov M Yu
Sevastopol City Hospital No. 5 - Center for Maternal and Child Health Protection, Sevastopol, Russia.
Sevastopol City Pirogov Hospital No. 1, Sevastopol, Russia.
Khirurgiia (Mosk). 2024(11):46-53. doi: 10.17116/hirurgia202411146.
To compare the incision and drainage of perianal abscess (ID) without fistulotomy with Gabriel procedure (GP) in neonates and infants with perianal abscess and fistula-in-ano.
A single-center retrospective comparative study included neonates and infants aged 1-12 months with first occuring perianal abscess and fistula-in-ano. Postoperative follow-up was 1 year. Abscess with fistula was confirmed in all patients.
The study included 31 boys (13 ones in the ID group, and 18 ones in the GP group). Clinical characteristics were similar in both groups. The cure rate in the OG group (100%, 18/18) was significantly higher than in the ID group (54%, 7/13; =0.002). Abscess recurrence was significantly less common in the OG group (=0.002). No fecal incontinence was observed in any patient. We analyzed the factors affecting the incidence of perianal abscess and fistula-in-ano recurrence using the odds ratio and 95% confidence interval (CI). There was no correlation between recurrence rate and positive bacteriological examination of postoperative wound as well as type of feeding (OR 0.5; 95% CI 0.07 - 3.55; =0.24, and OR 0.53; 95% CI 0.058 - 4.912; =0.15, respectively).
Recurrence rate is significantly lower after GP for perianal abscess and fistula-in-ano.
比较新生儿和婴幼儿肛周脓肿合并肛瘘时，肛周脓肿切开引流术（ID）不联合肛瘘切开术与加布里埃尔手术（GP）的疗效。
一项单中心回顾性对照研究纳入了1至12个月大首次发生肛周脓肿合并肛瘘的新生儿和婴幼儿。术后随访1年。所有患者均确诊为脓肿合并肛瘘。
该研究纳入31名男孩（ID组13名，GP组18名）。两组临床特征相似。OG组治愈率（100%，18/18）显著高于ID组（54%，7/13；P = 0.002）。OG组脓肿复发明显较少（P = 0.002）。未观察到任何患者出现大便失禁。我们使用比值比和95%置信区间（CI）分析了影响肛周脓肿和肛瘘复发发生率的因素。复发率与术后伤口细菌学检查阳性以及喂养方式之间无相关性（比值比分别为0.5；95% CI 0.07 - 3.55；P = 0.24，以及比值比0.53；95% CI 0.058 - 4.912；P = 0.15）。
对于肛周脓肿合并肛瘘，GP术后复发率显著更低。
