应用视频辅助下肛瘘治疗技术的肛瘘微创治疗  

Minimally invasive treatment on anal fistula assisted with video

作　　者：茹新宇[1] 柯梦 丁召[1] 万松林[1] 田翠萍 秦前波[1] 吴云华[1] 江从庆[1] 钱群[1] 

机构地区：[1]武汉大学中南医院结直肠肛门外科,430071

出　　处：《临床外科杂志》2017年第12期898-901,共4页Journal of Clinical Surgery

摘　　要：目的通过武汉大学中南医院结直肠肛门外科的初期实践对视频辅助下肛瘘治疗技术(VAAFT)进行疗效评价。方法收集2016年12月到2017年3月间应用视频辅助下肛瘘治疗技术治疗的肛瘘患者7例,随访时间1~4月,收集术前术后的临床资料并分析患者术后的外口愈合情况、并发症、疼痛、肛门括约肌功能。结果 5例患者成功完成手术,2例马蹄形肛瘘患者术中改行挂线手术。4例一期愈合,治愈率80%。一例未见外口闭合,伴外口溢液,手术失败可能与未完全闭合直肠壁上的多发内口有关。所有病人术后未出现严重并发症,但有两例出现会阴水肿,于术后2~3天消失。未出现尿潴留及肛门失禁,术后患者疼痛轻微。结论 VAAFT在限定的适应证下是一种具有许多优势的微创肛瘘治疗技术。Objective To evaluate the efficacy of video-assisted anal fistula treatment（ VAAFT）through preliminary practice in department of colorectal and anal surgery of Zhongnan Hospital of Wuhan University. Methods A total of 7 patients were received VAAFT from December 2016 to March 2017.Follow-up period was 1 to 4 months. The preoperative and postoperative data,external opening healing,complications,pain and the function of anal sphincter were recorded and analyzed. Results VAAFT was successfully conduced on five patients and two failed cases with horseshoe shaped anal fistulas were conduced seton surgery. Primary healing was achieved in 4 patients（ 80%） within 3 ~ 5 weeks after operation.In one case,healing was not achieved and the fistula had postoperative external opening discharge. The reason might be some missing internal openings beyond rectal wall existed. No major complications occurred. However,there were two cases with postoperative perineal edema,which disappeared 2 ~ 3 days later. Postoperative pain was mild and acceptable,and no incontinence and uroschesis occurred. Conclusion Under qualified inclusion criteria,VVAFT is a minimally invasive treatment of anal fistula with many advantages.

关 键 词：微创 肛瘘 视频辅助下肛瘘治疗技术 适应症 

分 类 号：R657.16[医药卫生—外科学]