Ding Yan, Xue Yahong, Miao Yaqiu, Zhu Huiting, Ye Rui, Wang Xiaofeng
Colorectal Surgery Center, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
Graduate College, Nanjing University of Chinese Medicine, Nanjing, China.
Front Med (Lausanne). 2025 May 16;12:1589278. doi: 10.3389/fmed.2025.1589278. eCollection 2025.
A high intersphincteric anal fistula is a common anorectal disease that is challenging to treat due to high recurrence rates and has the risk of sphincter damage, which can lead to incontinence. This study aimed to evaluate the efficacy and safety of the rectal incision, fistula excision, and reconstruction (RIFER) procedure for treating high intersphincteric anal fistulas.
Twenty-six patients with high intersphincteric anal fistulas who were admitted to Nanjing Hospital of Traditional Chinese Medicine between September 2021 and March 2024 and underwent the RIFER procedure were included. Patients were followed up for 6 months, and treatment efficacy, recurrence, and postoperative complications after the RIFER procedure were assessed.
The surgical cure rate of patients treated with RIFER was 100%, with no recurrence or postoperative complications during the follow-up period. The average wound-healing time was 45.40 days. Functional scoring indicators, such as the visual analog and Wexner anal function scores, improved at different postoperative time points. After the RIFER procedure, the incision scar score of most patients (18 of 25) was 0, and none of the patients reported keyhole-like anal deformities. The mean hospital stay was 10.15 days.
The RIFER procedure demonstrated remarkable efficacy and safety in the treatment of high intersphincteric anal fistulas, with no recurrence or postoperative complications. This procedure is suitable for treating high intersphincteric anal fistulas in clinical practice.
高位括约肌间肛瘘是一种常见的肛肠疾病，由于复发率高，治疗具有挑战性，且存在括约肌损伤的风险，可能导致大便失禁。本研究旨在评估直肠切开、瘘管切除及重建（RIFER）手术治疗高位括约肌间肛瘘的疗效和安全性。
纳入2021年9月至2024年3月期间在南京市中医院住院并接受RIFER手术的26例高位括约肌间肛瘘患者。对患者进行6个月的随访，评估RIFER手术后的治疗效果、复发情况及术后并发症。
接受RIFER手术治疗的患者手术治愈率为100%，随访期间无复发及术后并发症。平均伤口愈合时间为45.40天。视觉模拟评分和韦克斯纳肛门功能评分等功能评分指标在术后不同时间点有所改善。RIFER手术后，大多数患者（25例中的18例）的切口瘢痕评分为0，且无患者报告有锁孔状肛门畸形。平均住院时间为10.15天。
RIFER手术在治疗高位括约肌间肛瘘方面显示出显著的疗效和安全性，无复发及术后并发症。该手术适用于临床实践中高位括约肌间肛瘘的治疗。
