低位肛瘘合并痔同期手术的回顾性临床研究(附73例报道)  

Clinical study of combined surgery for low anal fistula and hemorrhoids:a retro⁃spective analysis of 73 cases

作　　者：万星阳[1] 苏丹[1] 张恒[1] 周茜[1] 林宏城[1] 彭慧[1] 谢尚奎[1] 任东林[1] Wan Xingyang;Su Dan;Zhang Heng;Zhou Qian;Lin Hongcheng;Peng Hui;Xie Shangkui;Ren Donglin(Department of Colorectal and Anal Surgery,The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,Guang-dong,China)

机构地区：[1]中山大学附属第六医院肛肠外科,广东广州510655

出　　处：《结直肠肛门外科》2020年第6期730-733,共4页Journal of Colorectal & Anal Surgery

基　　金：国家自然科学基金青年基金项目(81904213)。

摘　　要：目的总结低位肛瘘合并痔同期手术的外科治疗效果,并分析手术操作要点。方法回顾性分析2016年1月至2018年12月中山大学附属第六医院肛肠外科收治的73例低位肛瘘合并痔患者的临床资料,按照治疗方案的不同将患者分为A组(行单纯低位肛瘘切除术,n=31)和B组(行低位肛瘘同期联合痔手术,n=42)。比较两组手术时间及术后住院时间,术后随访并记录两组手术满意度、术后复发率以及Wexner肛门失禁评分。结果两组手术时间比较差异无统计学意义(P>0.05);A组术后住院时间短于B组,两组比较差异有统计学意义(P<0.05)。A组中位随访时间为2.2(2.0,3.8)年,B组中位随访时间为3.5(2.9,3.9)年。A组失访率为16.1%(5/31),B组失访率为14.3%(6/42),两组失访率比较差异无统计学意义(P>0.05)。两组手术满意度、术后复发率及Wexner肛门失禁评分比较,差异均无统计学意义(均P>0.05)。结论在把握个体化手术适应证的前提下,施行低位肛瘘合并痔的同期手术是可行的,未见增加术后复发及肛门失禁风险。Objectives To summarize the surgical technique and effect of combined surgical treatment for low anal fistula and hemorrhoids.Methods This was a retrospective analysis of 73 patients with low fistula and hemorrhoids at the Department of Colorectal and anal Surgery,The Sixth Affiliated Hospital of Sun Yat-sen University,between January 2016 and December 2018.According to different surgical treatment,patients were divided into Group A(received excision of low anal fistula,n=31)and Group B(received combined surgery for low anal fistula and hemorrhoids,n=42).Duration of surgery and postoperative hospital⁃ization were compared between the two groups.After surgery,patients were followed-up to assess their satisfaction,postoperative recurrence,and Wexner incontinence score.Results The duration of surgery did not differ significantly between the two groups(P>0.05).The duration of postoperative hospitalization was significantly shorter in Group A than in Group B(P<0.05).The medi⁃an follow-up time of Group A was 2.2(2.0,3.8)years,while the Group B was 3.5(2.9,3.9)years.The rate of lost-to-follow-up was 16.1%(5/31)in Group A and 14.3%(6/42)in Group B,with no significant between-group difference(P>0.05).The two groups were similar in patients’satisfaction,postoperative recurrence rate,and Wexner incontinence score(P>0.05).Conclusion It was feasible to combine surgery for low anal fistula and hemorrhoids when the surgeries were indicated for an individual pa⁃tient.The combined surgery had no additional risk for postoperative recurrence and anal incontinence.

关 键 词：低位肛瘘合并痔 同期手术 分期手术 

分 类 号：R657.16[医药卫生—外科学] R657.18[医药卫生—临床医学]