A Multicenter Clinical Trial in Operation of Integrate Subparagraph, Fenestration, Exclusion, Cut Expansion, Seton, Tube, and Drainage to Treat Complex Anal Fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HE Yongheng ¹ , XU Yanyao ¹ , TAN Zhengyang ¹ , LUO Yulian ¹ , GU Chengyi ² , LUO Jikong ² , TANG Qingzhu ² , LIU Shaoqiong ³ , CHENG Lixiang ³ , XIAO Jian ⁴ , ZHONG Yongzhi ⁴

1.National Focus on Anorectal Branch, The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine (Traditional Chinese Medicine Hospital of Hunan Province), Changsha 410005, China;

Corresponding author：

HE Yongheng , Email: heyongheng1964@163.com

Keywords：

Operation of integrate subparagraph, fenestration, exclusion, cut expansion, seton, tube, and drainage; Complex anal fistula; Multicenter clinical trial

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Objective To investigate the safety and effectiveness of the operation of integrate subparagraph, fenestration, exclusion, cut expansion, seton, tube, and drainage (ISFECSTD) to cure complex anal fistula. Methods Using randomized comparison and multicenter parallel experiment, the total number was 240: 120 patients in study group treated by ISFECSTD, and 120 patients in control group treated by extended cutting and seton operation. Then compared the safety and effectiveness between two groups. Results The clinical recovery rate of the study group was significantly higher than that in the control group （P lt;0.05）. The operation time and wound healing time in study group were significantly less than those in control group, and the scar area after wound healing was smaller than that in control group （P lt;0.01）. The decreased extents of anorectal pressures and rectal capacity feeling function after operation in study group were smaller than those in control group (P lt;0.01). Rectal and anal reflex function and healing of the endostoma, stem, and branch in study group were better than those in control group (P lt;0.05, P lt;0.01). Incidence of anal incontinence after operation in study group was significantly less than that in of anus-rectum structure and function, and has the merits of higher cure rate, shorter time of healing, smaller scar, less pain, etc. The method of ISFECSTD is worth being a new standardized operation in the clinical application.

Citation： HE Yongheng ,XU Yanyao,TAN Zhengyang,LUO Yulian,GU Chengyi,LUO Jikong,TANG Qingzhu,LIU Shaoqiong,CHENG Lixiang,XIAO Jian,ZHONG Yongzhi. A Multicenter Clinical Trial in Operation of Integrate Subparagraph, Fenestration, Exclusion, Cut Expansion, Seton, Tube, and Drainage to Treat Complex Anal Fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1270-1274. doi: Copy

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1. 赵鹏飞, 何永恒. 分段开窗旷置结合切扩/挂线置管引流术治疗复杂性肛瘘有效性的研究进展 [J]. 亚太传统医药, 2008; 4(11): 127-129.
2. 王东宏, 何永恒. 分段开窗旷置结合切扩挂线逆向置管冲洗引流术治疗复杂性肛瘘的安全性研究进展 [J]. 医学信息, 2009; 1(4): 1-3.
3. 何永恒, 王东宏, 胡响当，等. 分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性临床研究 [J]. 中医外治杂志, 2010; 19（2）: 5-7.
4. 何永恒, 赵鹏飞，谭正洋，等. 分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的有效性临床研究 [J]. 中医药临床杂志, 2010; 22（4）: 329-331.
5. 何永恒，王东宏，赵鹏飞，等. 分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的临床研究 [J]. 湖南中医药大学学报, 2010; 30（3）: 64-67.
6. 中华中医药学会肛肠分会. 痔、肛瘘、肛裂、直肠脱垂的诊断标准 [J]. 中国肛肠病杂志, 2004; 24(4): 42-43.
7. 国家中医药管理局中医药标准管理部门. 中华人民共和国中医药行业标准 [S]. 1995: 131.
8. 李春雨. 实用肛门手术学 [M]. 沈阳: 辽宁科技出版社, 2005: 204-206.
9. 丁义江. 丁氏肛肠病学 [M]. 北京：人民卫生出版社, 2006: 101-103.
10. 张荣在, 林新华, 余智涛，等. 肛瘘手术对直肠肛门反射影响的动力学研究 [J]. 结直肠肛门外科, 2007; 13(5): 285-287.
11. 赵宝明. 肛门直肠病诊断治疗学 [M]. 北京: 中国协和医科大学出版社, 2001: 38-43.
12. 丁义江. 丁氏肛肠病学 [M]. 北京：人民卫生出版社, 2006: 160.
13. 丁义江. 丁氏肛肠病学 [M]. 北京：人民卫生出版社, 2006: 271.
14. 张荣在, 林大鹏, 余智涛. 直肠肛门瘘手术前后肛肠的动力学改变 [J]. 中国胃肠外科杂志, 1999; 2(4): 217-219．.
15. 任东林. 肛瘘治疗的手术方式选择及评价 [J]. 中华胃肠外科杂志, 2007; 10(6): 510-511.
16. 何永恒, 杨亲昭, 李春眉，等. 分段开窗旷置结合切扩挂线术治疗长瘘道高位复杂肛瘘 [J]. 中国肛肠病杂志, 1998; 18(5): 18-19．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A Multicenter Clinical Trial in Operation of Integrate Subparagraph, Fenestration, Exclusion, Cut Expansion, Seton, Tube, and Drainage to Treat Complex Anal Fistula

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