肛瘘的外科治疗  

Surgical treatment of anal fistula

作　　者：曾宪东[1] 张勇[2] 

机构地区：[1]沈阳市第八人民医院普通外科,110024 [2]沈阳市肛肠医院4病房

出　　处：《中华胃肠外科杂志》2014年第12期1164-1166,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：肛瘘是常见的肛周疾病。肛瘘的治疗难点在于降低术后复发率与保护肛周括约肌。目前肛瘘外科治疗方法较多，但在临床应用中各种方法的应用指征与价值仍无定论。本文将综述国内肛瘘外科治疗方法的发展、现状、新技术的临床应用结果。在中国期刊数据库与万方数据裤中检索国内肛瘘外科治疗的相关文献，包括挂线治疗、肛瘘切开术与切除术、LIFT手术以及生物材料治疗和新技术应用的文献。肛瘘外科治疗方法较多但各有千秋，因此施行肛瘘的个体化综合治疗可最大限度的实现低复发率与最大限度的括约肌保护。肛瘘外科治疗新技术的产生实现了对传统治疗的最大限度的改良。临床医生仍需致力于微创技术的发明与改良。其次，将肛瘘外科治疗的重心转移至干预肛周脓肿后肛瘘的形成是另一值得尝试的治疗理念。Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place , so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

关 键 词：肛瘘 挂线 肛瘘切开术 肛瘘切除术 综述 

分 类 号：R657.1[医药卫生—外科学]