Oh C
Surgery. 1983 Feb;93(2):330-2.
Fifteen patients who had recurrent high anal fistulas were treated at the Mount Sinai Medical Center from 1975 to 1981--12 men and 3 women, all of whom had already undergone fistulectomies from one to four times elsewhere. The fistulas were managed with coring of the tract (complete extirpation), including side tracts, if present, and primary closure of the internal opening with advancement rectal mucosal flap distal to the original fistulous opening. Thirteen of 15 patients had satisfactory results; two patients required reoperation for recurrences. The advantages of the advancement flap technique over the staging division technique are discussed. We have found our procedure to be very useful for high anal fistulas, particularly for patients with recurrent high anal fistulas in whom there is already some degree of sphincter damage and scar formation.
1975年至1981年期间，西奈山医疗中心对15例复发性高位肛瘘患者进行了治疗，其中男性12例，女性3例，他们均已在其他地方接受过一至四次肛瘘切除术。采用瘘管挖除术（完整切除）处理肛瘘，包括侧支瘘管（如有），并在原瘘口远端推进直肠黏膜瓣对内口进行一期缝合。15例患者中有13例取得了满意的效果；2例患者因复发需要再次手术。讨论了推进瓣技术相对于分期切开技术的优势。我们发现我们的手术方法对高位肛瘘非常有用，特别是对于那些已经存在一定程度括约肌损伤和瘢痕形成的复发性高位肛瘘患者。
