Clinical Study On Treatment Of High Complex Anal Fistula By Improved Anal Sphincter Retention Virtual-hanging

Objective: The purpose of this study is to explore a more minimally invasive,safe and effective treatment of high complex anal fistula by comparing the difference of healing time,pain score,anal function and total curative effect between the improved anal sphincter retention Virtual-hanging and traditional low incision and high sling line.Methods: A total of 60 patients with complex and complicated anal fistula meeting the diagnostic criteria were randomly divided into the traditional low incision and high sling line group and improved anal sphincter retention Virtual-hanging group,30 cases in each group.Followed up for 6 months,from treatment cost,length of stay,and pain The score,wound healing time,anal incontinence score,anorectal manometry,total curative effect and recurrence rate were observed and studied,and conclusions were drawn based on statistical analysis of the results.Results:(1)There was no statistically significant difference in gender,age,course of disease,number of internal orifices and fistulas,previous surgical history,and preoperative Wexner anal incontinence score between the two groups,and they were comparable(P>0.05).(2)There was no significant difference in the length of stay and cost of hospitalization between the two groups of patients,indicating that the two types of surgical treatment of high-complexity anal fistula have the same effect on the length of stay and cost of hospitalization.(3)The pain VAS score of the virtual hanging group was lower than that of the solid hanging group on the 1st and 7th day after surgery,and the difference was statistically significant(P<0.01);There was no significant difference in pain scores between the two groups of patients on the1 st and 7th day after surgery(P>0.05).(4)The Wexner anal incontinence score in the patients at 3 months after operation was lower than that in the solid line group(P<0.05);within the group,the Wexner anal incontinence score at 3 months after the solid line was significantly higher than that before the operation(P<0.01)).(5)At 3 months after surgery,there was no significant difference in the resting pressure of the anal canal between the two groups(P>0.05);the average maximum systolic pressure of the anal canal in the solid thread group was significantly lower than that in the virtual thread group(P<0.01),indicating the presence of anus Risk of incontinence.(6)There was no significant difference in wound healing time and recurrence rate at 6months between the two groups(P>0.05);3 months after operation,the total effective rate was 90% in the virtual hanging thread group and 93.33% in the solid hanging thread group(P>0.05).During the 6-month follow-up,no adverse events occurred in the two groups.Conclusions:(1)The improved anal sphincter retention virtual-hanging for the treatment of high complex anal fistula is comparable to the traditional low incision and high hanging solid line in terms of hospital stay,hospitalization cost,wound healing time,cure rate,and recurrence,but it is effective.Reducing postoperative anal pain and lowering Wexner anal incontinence score are worth clinical promotion.(2)The AMCP of the anal canal is reduced after the incision of the lower incision and the high hanging thread is used in the treatment of high complex anal fistula.There is a risk of incontinence.