Yoon Sunseok, Choi Jung-Woo, Son Yongtaik, Lee Hyun Soon, Hong Kwang Dae
Department of Colorectal Surgery, Korea University Ansan Hospital, Ansan, Korea.
Department of Pathology, Korea University Ansan Hospital, Ansan, Korea.
Ann Coloproctol. 2025 Feb;41(1):84-92. doi: 10.3393/ac.2024.00626.0089. Epub 2025 Feb 26.
Anorectal fistulas present a treatment challenge, with conventional surgical methods potentially resulting in complications such as fecal incontinence. To improve patient outcomes, more effective and minimally invasive therapies are critically needed. In this study, an optimal porcine model for the creation of anorectal fistulas was developed and used to evaluate the efficacy of radiofrequency ablation (RFA) therapy.
Two distinct but related experiments were conducted. In the first experiment, a reliable and standardized porcine anorectal fistula model was developed. In the second, the healing process was assessed, and outcomes were compared between the RFA-treated group and the control group using the established porcine model.
The results indicated that a 3.5-cm fistula tract length and a 14-day evaluation period following seton removal are optimal for the porcine anorectal fistula model. In the second experiment, the RFA group tended to exhibit better outcomes regarding fistula closure, although the differences were not statistically significant. Histopathologically, no significant difference in inflammation grade was observed between groups; however, scar tissue was more predominant in the RFA group.
The findings suggest that RFA therapy may offer potential benefits in the treatment of anorectal fistulas, as demonstrated using a porcine model. To validate these results and explore the mechanisms of action underlying RFA therapy for anorectal fistulas, further research involving larger sample sizes and a more robust study design is required.
肛瘘的治疗具有挑战性，传统手术方法可能导致诸如大便失禁等并发症。为改善患者预后，迫切需要更有效且微创的治疗方法。在本研究中，建立了一种用于创建肛瘘的最佳猪模型，并用于评估射频消融（RFA）治疗的疗效。
进行了两个不同但相关的实验。在第一个实验中，建立了可靠且标准化的猪肛瘘模型。在第二个实验中，评估了愈合过程，并使用已建立的猪模型比较了RFA治疗组和对照组的结果。
结果表明，对于猪肛瘘模型，3.5厘米的瘘管长度和去除挂线后14天的评估期是最佳的。在第二个实验中，RFA组在瘘管闭合方面倾向于表现出更好的结果，尽管差异无统计学意义。组织病理学上，两组之间在炎症分级上未观察到显著差异；然而，RFA组的瘢痕组织更为突出。
研究结果表明，如使用猪模型所证明的，RFA治疗可能在肛瘘治疗中提供潜在益处。为验证这些结果并探索RFA治疗肛瘘的作用机制，需要进行涉及更大样本量和更稳健研究设计的进一步研究。
