經括約肌間瘺管結扎術治療復雜性肛瘺44例臨床療效觀察_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 安嘯海 ¹ , 程瀅瑞 ¹ , 高瑩 ¹ , 楊曉玲 ¹ ,  楊柏霖 ²

1. ;
2. ;

Corresponding?author：

楊柏霖, Email: blyang1971@163.com

Keywords：

復雜性肛瘺; 經括約肌間瘺管結扎術; 治愈率; 復發率

DOI：

10.7507/1007-9424.20160128

Video：

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目的評價經括約肌間瘺管結扎術在治療復雜性肛瘺中的臨床療效。方法對2009年9月至2014年12月期間南京中醫藥大學附屬醫院肛腸科收治的44例經括約肌肛瘺行括約肌間瘺管結扎術患者的臨床資料進行回顧性分析。結果 44例中獲一期治愈者36例（81.8%）；術后括約肌間感染2例，使用銀離子敷料換藥后治愈，4例出現括約肌間切口感染，形成括約肌間瘺，經直接切開后治愈；完全失敗2例，1例因術后癥狀持續而行掛線治療后治愈，另1例術后7個月復發（于其他醫院行肛瘺切開掛線術）。術后住院時間10～25 d，平均14.7 d；傷口完全愈合時間15～30 d，平均21.1 d。結論經括約肌間瘺管結扎術是一種簡單、有效的保留括約肌術式，該手術減少了對肛門功能的損傷，保證括約肌的完整性。

Citation： 安嘯海, 程瀅瑞, 高瑩, 楊曉玲, 楊柏霖. 經括約肌間瘺管結扎術治療復雜性肛瘺44例臨床療效觀察. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 484-486. doi: 10.7507/1007-9424.20160128 Copy

1.	Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai, 2007, 90(3):581-586.
2.	Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum, 1993, 36(1):77-97.
3.	Tan KK, Tan IJ, Lim FS, et al. 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.
4.	Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Dis Colon Rectum, 2011, 54(3):289-292.
5.	Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure:the Western Hospital experience. Colorectal Dis, 2012, 14(5):599-603.
6.	Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula:early results from a prospective observational study. Tech Coloproctol, 2011, 15(4):413-416.
7.	Ellis CN. Outcomes with the use of bioprosthetic grafts to reinforce the ligation of the intersphincteric fistula tract (BioLIFT procedure) for the management of complex anal fistulas. Dis Colon Rectum, 2010, 53(10):1361-1364.
8.	Yassin NA, Hammond TM, Lunniss PJ, et al. Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review. Colorectal Dis, 2013, 15(5):527-535.
9.	Tan KK, Alsuwaigh R, Tan AM, et al. To LIFT or to flap? Which surgery to perform following seton insertion for high anal fistula?. Dis Colon Rectum, 2012, 55(12):1273-1277.
10.	Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. Am J Surg, 2012, 204(3):283-289.
11.	Wallin UG, Mellgren AF, Madoff RD, et al. Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?. Dis Colon Rectum, 2012, 55(11):1173-1178.
12.	Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT):a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum, 2010, 53(1):39-42.
13.	van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistulae:a new technique to avoid fistulotomy. Colorectal Dis, 2013, 15(5):587-591.
14.	Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract:an effective new technique for complex fistulas. Dis Colon Rectum, 2010, 53(1):43-46.
15.	Liu WY, Aboulian A, Kaji AH, et al. Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula-in-ano. Dis Colon Rectum, 2013, 56(3):343-347.

1. Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai, 2007, 90(3):581-586.
2. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum, 1993, 36(1):77-97.
3. Tan KK, Tan IJ, Lim FS, et al. 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.
4. Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano. Dis Colon Rectum, 2011, 54(3):289-292.
5. Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure:the Western Hospital experience. Colorectal Dis, 2012, 14(5):599-603.
6. Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula:early results from a prospective observational study. Tech Coloproctol, 2011, 15(4):413-416.
7. Ellis CN. Outcomes with the use of bioprosthetic grafts to reinforce the ligation of the intersphincteric fistula tract (BioLIFT procedure) for the management of complex anal fistulas. Dis Colon Rectum, 2010, 53(10):1361-1364.
8. Yassin NA, Hammond TM, Lunniss PJ, et al. Ligation of the intersphincteric fistula tract in the management of anal fistula. A systematic review. Colorectal Dis, 2013, 15(5):527-535.
9. Tan KK, Alsuwaigh R, Tan AM, et al. To LIFT or to flap? Which surgery to perform following seton insertion for high anal fistula?. Dis Colon Rectum, 2012, 55(12):1273-1277.
10. Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage. Am J Surg, 2012, 204(3):283-289.
11. Wallin UG, Mellgren AF, Madoff RD, et al. Does ligation of the intersphincteric fistula tract raise the bar in fistula surgery?. Dis Colon Rectum, 2012, 55(11):1173-1178.
12. Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT):a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum, 2010, 53(1):39-42.
13. van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistulae:a new technique to avoid fistulotomy. Colorectal Dis, 2013, 15(5):587-591.
14. Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract:an effective new technique for complex fistulas. Dis Colon Rectum, 2010, 53(1):43-46.
15. Liu WY, Aboulian A, Kaji AH, et al. Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula-in-ano. Dis Colon Rectum, 2013, 56(3):343-347.

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經括約肌間瘺管結扎術治療復雜性肛瘺44例臨床療效觀察

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