Prospective clinical study of modified LIFT combined with acellular anal fistula repair matrix packing in the treatment of high anal fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HAN Xu , ZHAO Tuanjie , LIU Liancheng , HUANG Bin , REN Chuncheng , WANG Min , ZHANG Zhiliang , SU Yue ,  ZHANG Yuru

Department of Anus & Intestine Surgery, Beijing Anorectal Hospital (Beijing Erlonglu Hospital), Beijing 100120, P. R. China;

Corresponding?author：

ZHANG Yuru, Email: zhyr_11@163.com

Keywords：

modified ligation of intersphincteric fistula tract; acellular anal fistula repair matrix; high anal fistula; minimal invasive; packing

DOI：

10.7507/1007-9424.202010100

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To observe the effect of modified ligation of intersphincteric fistula tract (LIFT) combined with acellular anal fistula repair matrix packing in the treatment of high anal fistula, and to evaluate its clinical efficacy and safety.Methods All 86 patients who met the diagnostic criteria of high anal fistula in Beijing Anorectal Hospital from October 2018 to August 2019 were selected and randomly divided into observation group and control group. The observation group was treated with modified LIFT combined with acellular anal fistula repair matrix tamponade, while the control group was treated with traditional low incision and high thread drawing surgery. The curative effect, wound healing time, postoperative pain score, intraoperative blood loss, postoperative complications, hospitalization time, patient satisfaction and recurrence at 6 months after operation were compared between the two groups.Results The effective rate of the observation group was 92.9% (39/42), and that of the control group was 86.4% (38/44), there was no significant difference between the two groups (Z=?1.251, P=0.211). The healing time of the observation group and the control group were (24.8±8.5) days and (32.1±10.9) days, respectively, the difference was statistically significant (t=3.472, P<0.001). Compared with the control group, the observation group had less intraoperative blood loss, less postoperative pain and shorter hospital stay (P<0.05). There was no anal incontinence after operation in the two groups, and the incidence of postoperative complications such as bloody stool, anal border edema and urinary retention were lower in the observation group (11.9%) compared with the control group (31.8%), with a statistically significant difference (P<0.05). The treatment satisfaction of the observation group was 90.5%, and that of the control group was 81.8%. There was no significant difference between the two groups (Z=?1.284, P>0.05).Conclusion Modified LIFT combined with acellular anal fistula repair matrix in the treatment of high anal fistula has the advantages of small trauma, quick recovery and low incidence of complications.

Citation： HAN Xu, ZHAO Tuanjie, LIU Liancheng, HUANG Bin, REN Chuncheng, WANG Min, ZHANG Zhiliang, SU Yue, ZHANG Yuru. Prospective clinical study of modified LIFT combined with acellular anal fistula repair matrix packing in the treatment of high anal fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 751-756. doi: 10.7507/1007-9424.202010100 Copy

1.	Owen HA, Buchanan GN, Schizas A, et al. Quality of life with anal fistula. Ann R Coll Surg Engl, 2016, 98(5): 334-338.
2.	中國醫師協會肛腸醫師分會臨床指南工作委員會. 肛瘺診治中國專家共識(2020版). 中華胃腸外科雜志, 2020, 23(12): 1123-1130.
3.	趙云, 肖維, 高哲. 改良 LIFT 治療復雜性肛瘺的臨床療效研究. 中國現代醫學雜志, 2018, 28(2): 78-81.
4.	Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol, 2015, 21(1): 12-20.
5.	黃斌, 張玉茹, 劉連成, 等. 視頻輔助治療高位肛瘺58例報道. 中國中西醫結合外科雜志, 2020, 26(2): 163-165.
6.	Oldfield F, Gilbert T, Skaife P. Is modern management of fistula-in-ano acceptable? Br J Hosp Med (Lond), 2016, 77(7): 388-393.
7.	Kouchi K, Takenouchi A, Matsuoka A, et al. Efficacy of an anal fistula plug for fistulas-in-ano in children. J Pediatr Surg, 2017, 52(8): 1280-1282.
8.	Xu Y, Tang W. Comparison of an anal fistula plug and mucosa advancement flap for complex anal fistulas: a meta-analysis. ANZ J Surg, 2016, 86(12): 978-982.
9.	Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
10.	Marref I, Spindler L, Aubert M, et al. The optimal indication for FiLaC? is high trans-sphincteric fistula-in-ano:a prospective cohort of 69 consecutive patients. Tech Coloproctol, 2019, 23(9): 893-897.
11.	Lauretta A, Falco N, Stocco E, et al. Anal fistula laser closure: the length of fistula is the Achilles’heel. Tech Coloproctol, 2018, 22(12): 933-939.
12.	Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol, 2011, 15(4): 417-422.
13.	Adegbola SO, Sahnan K, Pellino G, et al. Short-term efficacy and safety of three novel sphincter-sparing techniques for anal fistulae: a systematic review. Tech Coloproctol, 2017, 21(10): 775-782.
14.	Zarin M, Khan MI, Ahmad M, et al. VAAFT: video assisted anal fistula treatment; bringing revolution in fistula treatment. Pak J Med Sci, 2015, 31(5): 1233-1235.
15.	張祎, 宮愛民. 經括約肌間瘺管結扎術治療前位肛瘺療效觀察. 大連醫科大學學報, 2018, 40(3): 234-237, 246.
16.	Yassin NA, Hammond TM, Lunniss PJ, et al. Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review. Colorectal Disease, 2013, 15(5): 527-535.
17.	王帥軍. 經括約肌間瘺管結扎術治療低位單純性肛瘺療效觀察. 實用中西醫結合臨床, 2020, 20(10): 24-25.
18.	蔣進廣, 王猛, 陳娟, 等. 經括約肌間瘺管結扎術治療經括約肌肛瘺的臨床研究. 中國肛腸病雜志, 2016, 36(4): 20-22.
19.	陳紅錦, 谷云飛, 孫桂東, 等. 經括約肌間瘺管結扎術治療復雜性肛瘺. 中華胃腸外科雜志, 2014, 17(12): 1190-1193.
20.	劉揚, 路明. 經括約肌間瘺管結扎術治療高位單純性肛瘺的前瞻性臨床對比研究. 中國普外基礎與臨床雜志, 2020, 27(2): 143-146.
21.	Vogel JD, Johnson EK, Morris AM, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum, 2016, 59(12): 1117-1133.
22.	Hong KD, Kang S, Kalaskar S, et al. Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula:systematic review and meta-analysis. Tech Coloproctol, 2014, 18(8): 685-691.
23.	Tan KK, Tan IJ, Lim FS, et a1. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum, 2011, 54(11): 1368-1372.
24.	李冬生. 改良LIFT術和常規LIFT術治療單純性經括約肌型肛瘺的比較分析. 國際醫藥衛生導報, 2015, 21(15): 2177-2180.
25.	王振軍. 肛瘺治療新手術: LIFT-Plug術. 中國臨床醫生, 2011, 39(8): 8-9.
26.	趙丹丹, 李春雨. LIFT-Pplug術式治療經括約肌型肛瘺的療效及安全性. 中國現代普通外科進展, 2017, 20(5): 386-388.
27.	吳博, 王競, 凌光烈. 改良經擴約肌間瘺管結扎術-Plug術治療低位肛瘺療效分析. 山西醫藥雜志, 2013, 42(7): 434-436.

1. Owen HA, Buchanan GN, Schizas A, et al. Quality of life with anal fistula. Ann R Coll Surg Engl, 2016, 98(5): 334-338.
2. 中國醫師協會肛腸醫師分會臨床指南工作委員會. 肛瘺診治中國專家共識(2020版). 中華胃腸外科雜志, 2020, 23(12): 1123-1130.
3. 趙云, 肖維, 高哲. 改良 LIFT 治療復雜性肛瘺的臨床療效研究. 中國現代醫學雜志, 2018, 28(2): 78-81.
4. Limura E, Giordano P. Modern management of anal fistula. World J Gastroenterol, 2015, 21(1): 12-20.
5. 黃斌, 張玉茹, 劉連成, 等. 視頻輔助治療高位肛瘺58例報道. 中國中西醫結合外科雜志, 2020, 26(2): 163-165.
6. Oldfield F, Gilbert T, Skaife P. Is modern management of fistula-in-ano acceptable? Br J Hosp Med (Lond), 2016, 77(7): 388-393.
7. Kouchi K, Takenouchi A, Matsuoka A, et al. Efficacy of an anal fistula plug for fistulas-in-ano in children. J Pediatr Surg, 2017, 52(8): 1280-1282.
8. Xu Y, Tang W. Comparison of an anal fistula plug and mucosa advancement flap for complex anal fistulas: a meta-analysis. ANZ J Surg, 2016, 86(12): 978-982.
9. Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
10. Marref I, Spindler L, Aubert M, et al. The optimal indication for FiLaC? is high trans-sphincteric fistula-in-ano:a prospective cohort of 69 consecutive patients. Tech Coloproctol, 2019, 23(9): 893-897.
11. Lauretta A, Falco N, Stocco E, et al. Anal fistula laser closure: the length of fistula is the Achilles’heel. Tech Coloproctol, 2018, 22(12): 933-939.
12. Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol, 2011, 15(4): 417-422.
13. Adegbola SO, Sahnan K, Pellino G, et al. Short-term efficacy and safety of three novel sphincter-sparing techniques for anal fistulae: a systematic review. Tech Coloproctol, 2017, 21(10): 775-782.
14. Zarin M, Khan MI, Ahmad M, et al. VAAFT: video assisted anal fistula treatment; bringing revolution in fistula treatment. Pak J Med Sci, 2015, 31(5): 1233-1235.
15. 張祎, 宮愛民. 經括約肌間瘺管結扎術治療前位肛瘺療效觀察. 大連醫科大學學報, 2018, 40(3): 234-237, 246.
16. Yassin NA, Hammond TM, Lunniss PJ, et al. Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review. Colorectal Disease, 2013, 15(5): 527-535.
17. 王帥軍. 經括約肌間瘺管結扎術治療低位單純性肛瘺療效觀察. 實用中西醫結合臨床, 2020, 20(10): 24-25.
18. 蔣進廣, 王猛, 陳娟, 等. 經括約肌間瘺管結扎術治療經括約肌肛瘺的臨床研究. 中國肛腸病雜志, 2016, 36(4): 20-22.
19. 陳紅錦, 谷云飛, 孫桂東, 等. 經括約肌間瘺管結扎術治療復雜性肛瘺. 中華胃腸外科雜志, 2014, 17(12): 1190-1193.
20. 劉揚, 路明. 經括約肌間瘺管結扎術治療高位單純性肛瘺的前瞻性臨床對比研究. 中國普外基礎與臨床雜志, 2020, 27(2): 143-146.
21. Vogel JD, Johnson EK, Morris AM, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum, 2016, 59(12): 1117-1133.
22. Hong KD, Kang S, Kalaskar S, et al. Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula:systematic review and meta-analysis. Tech Coloproctol, 2014, 18(8): 685-691.
23. Tan KK, Tan IJ, Lim FS, et a1. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum, 2011, 54(11): 1368-1372.
24. 李冬生. 改良LIFT術和常規LIFT術治療單純性經括約肌型肛瘺的比較分析. 國際醫藥衛生導報, 2015, 21(15): 2177-2180.
25. 王振軍. 肛瘺治療新手術: LIFT-Plug術. 中國臨床醫生, 2011, 39(8): 8-9.
26. 趙丹丹, 李春雨. LIFT-Pplug術式治療經括約肌型肛瘺的療效及安全性. 中國現代普通外科進展, 2017, 20(5): 386-388.
27. 吳博, 王競, 凌光烈. 改良經擴約肌間瘺管結扎術-Plug術治療低位肛瘺療效分析. 山西醫藥雜志, 2013, 42(7): 434-436.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Prospective clinical study of modified LIFT combined with acellular anal fistula repair matrix packing in the treatment of high anal fistula

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content