改良TROPIS手术与切开挂线术治疗高位肛瘘的疗效及对术后功能恢复的影响  

Effect of modified TROPIS operation and open and hanging operation on high anal fistula and its effect on postoperative recovery and function

作　　者：陈长亮 姜国丹[1] 刘慧峰[1] 周晓娟[1] 李南[1] Chen Changliang;Jiang Guodan;Liu Huifeng;Zhou Xiaojuan;Li Nan(Department of General Surgery,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院普外科,北京101100

出　　处：《中华内分泌外科杂志(中英文)》2025年第1期106-109,共4页Chinese Journal of Endocrine Surgery

基　　金：北京通州区科技计划项目(KJ2019CX012-05)。

摘　　要：目的:探讨改良经肛括约肌间切开术(TROPIS)与切开挂线术治疗高位肛瘘的疗效及对术后功能恢复的影响。方法:选取首都医科大学附属北京潞河医院普外科2023年1月至2024年6月收治的92例高位肛瘘患者作为研究对象,按照随机分组法分为改良组(实施改良TROPIS手术)45例与对照组(采用切开挂线术)47例,观察两组临床疗效,术后恢复情况,生活质量及并发症情况。结果:与对照组相比,改良组手术时间、术中出血量、术后住院时间分别为手术时间和出血量均显著低于对照组(P<0.05)。改良组肛瘘愈合时间为(28.01±5.02)d,低于对照组的(35.05±7.09)d;改良组愈合率为97.78%,高于对照组的80.85%;改良组复发率为4.44%,低于对照组的19.14%(P<0.05)。改良组术后疼痛程度与Wexner肛门失禁评分低于对照组(P<0.05),生活质量评分高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:改良TROPIS手术在治疗肛瘘方面有显著优势,该术式不仅可有效清除感染灶,还可最大限度地保护肛门功能,减少手术创伤和术后并发症风险,有望成为未来肛瘘治疗的主流术式。Objective:To investigate the effects of modified TROPIS surgery,incorporating both open and hanging stitches on the treatment of elevated anal fistula.Methods:For our study,92 patients with high anal fistula,admitted between Jan.2023 and Jun.2024,were selected.They were divided into two categories:the observation group(45 modified TROPIS surgery)and the control group(47 cuts),to observe the clinical efficacy,postoperative recovery,quality of life and complications of the two groups.Results:Compared with the control group,the operation time,intraoperative blood loss and postoperative hospitalization time decreased in the observation group(P<0.05).Compared with the control group,the healing time of anal fistula in the observation group was(28.01±5.02)d,shorter than that in the control group(35.05±7.09)d,the healing rate was 97.78%,higher than that in the control group(80.85%),and the recurrence rate was 4.44%,lower than that in the control group(19.14%)(P<0.05).The degree of postoperative pain and Wexner anal incontinence score in the observation group were lower than those in the control group(P<0.05).The life quality score of the observation group was higher than that of the control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).Conclusions:The modified TROPIS surgical method evidently provides advantages in anal fistula treatment.It can not only efficiently eliminate infections but also reduce anal movements and decrease the chances of post-surgical injuries and complications,presenting enhanced clinical options and suggesting a promising outlook for traditional anal fistula surgery.

关 键 词：改良TROPIS手术 切开挂线术 高位肛瘘 肛门功能 

分 类 号：R65[医药卫生—外科学]