Wang Xun, Pan Lili, Qiu Yanyan, Liu Tingbo
Department of Proctology, Fujian Provincial People's Hospital, Fuzhou, Fujian, P.R. China.
Fujian Provincial Key Laboratory on Hematology, Department of Pediatric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, P.R. China.
BMC Gastroenterol. 2025 Apr 11;25(1):246. doi: 10.1186/s12876-025-03848-5.
Perianal abscess (PA) is a complication of infection in patients with hematologic malignancies. However, the simultaneous occurrence of neutropenia and increased susceptibility to bleeding pose significant challenges for surgical intervention in perianal abscesses. In this retrospective study, we sought to evaluate and compare the efficacy of pharmacological therapy and surgical intervention in the management of PA in patients with hematologic malignancies, bwtween 2015 and 2022 at the Fujian Medical University Union Hospital. In total, 53 patients were enrolled in this study, including 19 cases with surgical intervention, and 34 cases with conservative treatment. During the 60-day follow-up period, a significant improvement of symptoms or complete resolution was observed in 48 patients (90.5%). But the cure rates between the two groups showed no significant difference (p > 0.05). Additionally, the surgical group demonstrated a significantly lower recurrence rate compared to the conservative group, while there was no statistically significant disparity in recurrence rates (10.4% vs. 23.6%, p > 0.05). Patients with conservative treatment showed significantly shorter recovery time compared to patients with surgical treatment (p = 0.048). In conclusion, both conservative and surgical management approaches were safe and effective in relieving symptoms, but surgical intervention significantly decreased the recurrence rate. Therefore, consideration of surgical intervention is warranted for patients with recurrent perianal infections after conservative treatment.
肛周脓肿(PA)是血液系统恶性肿瘤患者感染的一种并发症。然而,中性粒细胞减少和出血易感性增加同时出现,给肛周脓肿的手术干预带来了重大挑战。在这项回顾性研究中,我们旨在评估和比较2015年至2022年期间在福建医科大学附属协和医院接受治疗的血液系统恶性肿瘤患者中,药物治疗和手术干预在肛周脓肿管理中的疗效。本研究共纳入53例患者,其中19例接受手术干预,34例接受保守治疗。在60天的随访期内,48例患者(90.5%)症状有显著改善或完全缓解。但两组的治愈率无显著差异(p>0.05)。此外,手术组的复发率明显低于保守组,尽管复发率无统计学显著差异(10.4%对23.6%,p>0.05)。与手术治疗的患者相比,保守治疗的患者恢复时间明显更短(p=0.048)。总之,保守治疗和手术治疗方法在缓解症状方面都是安全有效的,但手术干预显著降低了复发率。因此,对于保守治疗后肛周感染复发的患者,有必要考虑手术干预。