The Clinical Research Of Therapy For Anal Fistula With Video-Assisted Anal Fistula Treatment

Objective:To observe the clinical effect of video-assisted anal fistula fistula in the treatment of anal fistula.To explore the new surgical treatment of anal fistula with minimally invasive surgery.Methods:A total of 116 cases of patients with anal fistula in line with the inclusion criteria for surgery were selected from the hospitalized patients,which hospitalized in gastrointestinal anal surgery area of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine Hospital from December 1,2016 to November 30,2017.According to the principle ofrandomised control principle,the cases were divided into the experimental group and the control group,each grouphas58cases.The experimental group was anal fistula with video-assisted,while the control group was fistula incision drainage with line drainage.Two sets of clinical data were collected.The clinical data included cure rate,postoperative pain score,wound excretion score,anal incontinencescore,analmorphologicalscore,analstenosis score,intraoperativebleeding,operationtime,postoperativehospital days,the total cost of hospitalization,etc.The results were analyzed by SPSS 21.0 statistical.Results:The cure rate was 82.8%(48/58)in the experimental group and 86.2%(50/58)in the control group.According to the analyze,the result shows that the difference of cure rate between two group was not statistically significant(χ~2=0.97,P>0.05).There was significant difference between the two groups in the day 3 of pain score,the test group was significantly lower than the control group(t=-3.02,P<0.05),but the pain score on day 1(t=-1.28,P>0.05)and day 7(t=-1.52,P>0.05)nearly same.The difference of wound secretion score between the two groups on day 1 and day 3 was obvious,and the experimental group was significantly better than the control group(t=-3.87,P<0.01;t=-3.52,P<0.05),but there were no significant difference on day 7(t=-1.17,P>0.05).Anal incontinence scores were significantly different between the two groups at 3 months of follow-up,and the result shows that the scores of the test group was significantly better than the control group(t=-4.54,P<0.01).Anal morphological score of the two groups were significantly different at 3 months of follow-up.and the result shows that the scores of the experimental group was significantly better than the control group(χ~2=16.93,P<0.01).Two groups did not appear anal stenosis,so the anal stenosis has no statistically significant.The experimental group effect in operation time(t=4.50,P<0.01),postoperative hospital days(t=3.20,P<0.05),the total cost of hospitalization(t=4.08,P<0.01)obviously higher than the control group.There was no significant difference between the two groups in gender(χ~2=0.29,P>0.05),BMI(t=0.23,P>0.05),anal fistula type(χ~2=2.18,P>0.05;χ~2=1.85,P>0.05),history(χ~2=0.35,P>0.05),intraoperative bleeding(t=0.48,P>0.05),so the result has no statistically significant.Conclusions:Anal fistula with video-assisted has the advantages of small trauma,safety and effectiveness,and protecting the anal function under the premise of ensuring the cure rate.The result shows that Anal fistula with video-assisted is an innovative surgical treatment of anal fistula and worth clinical promotion.