Gemsenjäger E
Chirurgische Klinik, Spital Neumünster, Zollikerberg/Zürich.
Schweiz Med Wochenschr. 1996 Nov 23;126(47):2021-5.
Eleven patients with suprasphincteric, translevatoric, or high transsphincteric fistula and 10 patients with low (transsphincteric or intersphincteric) fistula were treated by fistulectomy using sphincterotomy or a transsphincteric approach, with primary sphincter reconstruction. After a follow-up of 2-9 months one patient had a recurrence and in a further patient the internal anal sphincteric suture had become dehiscent, necessitating sphincteroplasty. 20 patients (95%) had a perfect anatomic and clinical functional result without recurrence. Fistulectomy with primary closure proved to be a safe treatment modality for primary and recurrent high and low fistula, with the advantages of rapid wound healing and of avoidance of continence disturbance due to sphincter division, anal canal deformity, or mucosal flap ectropion.
11例患有括约肌上型、经提肛肌型或高位经括约肌型肛瘘的患者以及10例患有低位（经括约肌型或括约肌间型）肛瘘的患者接受了采用括约肌切开术或经括约肌入路的瘘管切除术，并进行了一期括约肌重建。经过2至9个月的随访，1例患者出现复发，另有1例患者的肛门内括约肌缝线裂开，需要进行括约肌成形术。20例患者（95%）获得了完美的解剖和临床功能结果，无复发。一期缝合的瘘管切除术被证明是治疗原发性和复发性高位及低位肛瘘的一种安全治疗方式，具有伤口愈合快以及避免因括约肌切开、肛管畸形或黏膜瓣外翻导致的控便障碍的优点。
