Clinical Effectiveness of Sphincter Preservation Method of Improved Minimally Invasive Surgery to Primary Cure for Horseshoe-Shaped Perianal Abscess_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENZhao-hui ¹ ,  CHENLin ¹ , CHENHong-xia ¹ , ZHANGRui-fang ¹ , FANYong-qiang ¹ , MAOHong ²

1. Department of Coloproctology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China;
2. Depart-ment of Coloproctology, The Second Traditional Chinese Medicine Hospital of Sichuan Province, Chengdu 610031, Sichuan Province, China;

Corresponding?author：

CHENLin, Email: 151484833@qq.com

Keywords：

Perianal abscess; Surgery; Minimally invasive; Effectiveness

DOI：

10.7507/1007-9424.20160249

Video：

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Objective To evaluate clinical curative effect of sphincter preservation method of improved minimally invasive surgery to primary cure for horseshoe-shaped perianal abscess. Methods One hundred and twenty hospitalized patients diagnosed as horseshoe-shaped perianal abscess were analyzed by prospective, random, single-blind, parallel-group design method, and were randomly divided into two groups, one group of sphincter preservation method of improved minimally invasive surgery (observation group), another group of traditional method of hanging line drainage and multiple incisions of radian shape (control group). The cure rate, long-term recurrence, postoperative pain score within 9 d, hospitalization time, incision healing time, scar area after healing, postoperative anal function score and perioperative and long-term complications were compared in these two groups. Results All the operations were successfully completed in these two groups. There were 56 cases of primary healing in the observation group and 55 cases of primary healing in the control group. Compared with the control group, the postoperative pain score on day 2-4 or on day 7-9 was lower (P < 0.05), the incision healing time was shorter (P < 0.05), and the postoperative anal function score was lower (P < 0.05) in the observation group. There was no incision infection and hemorrhoea in these two groups. The hospitalization time, scar area after healing, incidence rate of urinary retention, hepatic and renal dysfunction, and the total white blood cells > 10.0×10⁹/L had no significant differences between these two groups (P > 0.05). There was no long-term recurrence, anal stenosis, and anal incontinence during following-up of 6 months in these two groups. Conclusion Preliminary research results show that sphincter preservation method of improved minimally invasive surgery to primary cure for horseshoe-shaped perianal abscess has a reliable clinical curative effect, fast healing, and less postoperative complications.

Citation： CHENZhao-hui, CHENLin, CHENHong-xia, ZHANGRui-fang, FANYong-qiang, MAOHong. Clinical Effectiveness of Sphincter Preservation Method of Improved Minimally Invasive Surgery to Primary Cure for Horseshoe-Shaped Perianal Abscess. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(8): 948-952. doi: 10.7507/1007-9424.20160249 Copy

1.	?國家中醫藥管理局.中醫病證診斷療效標準.南京:南京大學出版社, 1994:332.
2.	Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health, 1990, 13(4):227-236.
3.	Kloth LC, Feedar JA. Acceleration of wound healing with high voltage, monophasic, pulsed current. Phys Ther, 1988, 68(5):503-508.
4.	Jorge JM, Wexner SD. Etiology and management of faecal ineontinence. Dis Colon Rectum, 1993, 36(1):77-97.
5.	張文兵.仙方活命飲配合手術引流與外科手術治療肛周膿腫的療效比較.中國普通外科雜志, 2012, 21(8):1045-1046.
6.	袁鹿, 李春雨, 王墨飛, 等.肛周膿腫的治療.山西醫藥雜志:下半月, 2010, 39(6):505-506.
7.	Macdonald A, Wilson-Storey D, Munro F. Treatment of perianal abscess and fistula-in-ano in children. Br J Surg, 2003, 90(2):220-221.
8.	章陽, 王業皇, 宗海峰, 等.丁氏痔科中位掛線改良緊線法治療高位復雜性肛瘺的臨床研究.時珍國醫國藥, 2013, 24(8):1943-1945.
9.	Buddicom E, Jamieson A, Beasley S, et al. Perianal abscess in children: aiming for optimal management. ANZ J Surg, 2012, 82(1/2):60-62.
10.	Murthi GV, Okoye BO, Spicer RD, et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8):689-691.
11.	王浩, 谷云飛.肛周膿腫一期治療的術式探討.局解手術學雜志, 2010, 19(4):342-343.
12.	Deroide G, Deroide JP. Anal fistula and abscesses:diagnostic and therapeutic aspects, excepting Crohn's disease. J Chir (Paris), 2000, 137(2):83-92.
13.	黃潔夫.腹部外科學.北京:人民衛生出版社, 2001:1054.
14.	李二建.一次性根治術治療高位蹄鐵型膿腫的臨床觀察.中國醫藥導報, 2009, 6(32):132, 136.
15.	Ezer SS, O?uzkurt P, Ince E, et al. Perianal abscess and fistula-in-ano in children:aetiology, management and outcome. J Paediatr Child Health, 2010, 46(3):92-95.
16.	張海鷹, 邱運梅, 金艷玲.保留皮橋切開根治術治療肛周膿腫臨床觀察.牡丹江醫學院學報, 2007, 28(4):67-68.
17.	王偉, 李忠卓.窗式引流掛線術治療馬蹄形肛周膿腫126例.中國實用鄉村醫生雜志, 2007, 14(3):59.
18.	李秀萍, 陳達恭, 董全進.肛旁膿腫行Ⅰ期根治性手術療效的探討.大腸肛門病外科雜志, 2005, 11(2):30.
19.	宋玉柱.一期手術根治瘺管性肛周膿腫的術式探討-附60例病例觀察.中醫藥臨床雜志, 2005, 17(4):385-386.
20.	林先強, 李勝.多切口引流術治療蹄鐵型膿腫39例.中國肛腸病雜志, 2005, 25(5):54.
21.	邵小彬.一期手術治療肛周膿腫.外科理論與實踐, 2014, 19(1):64-65.
22.	劉剛.肛周膿腫一期根治性手術的探討.天津醫學雜志, 2007, 35(5):334.
23.	阮超群, 蔣慧娟. Ⅰ期根治肛周膿腫的臨床分析.中國現代實用醫學雜志, 2008, 7(11):34-35.
24.	Whiteford MH, Kilkenny J 3rd, Hyman N, et al. American Society of Colon and Rectal Surgeons. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised). Dis Colon Rectum, 2005, 48(7):1337-1342.
25.	Chang SC, Lin JK. Change in anal continence after surgery for intersphincteral anal fistula:a functional and manometric study. Int J colorectal Dis, 2003, 18(2):111-115.
26.	胡伯虎, 史兆岐, 周濟民.犬肛門括約肌切開與掛線對直腸肛門管靜止壓的影響及組織病理學觀察.中醫雜志, 1983, 24(4):68-70.
27.	應文輝譯.結腸直腸疾病.昆明:云南大學出版社, 1991:209.
28.	李慶恩, 李春英.一次性切開引流掛線法治療肛周膿腫臨床對照觀察.黑龍江醫藥科學, 2013, 36(4):65.
29.	翟金榮.兩種術式治療肛周高位膿腫療效觀察.浙江中西醫結合雜志, 2007, 17(8):505-506.
30.	錢海華.保護肛腸環治療高位膿腫39例臨床觀察.長春中醫學院學報, 2003, 19(4):31-32.
31.	孫剛, 顧汝軍, 劉冬良, 等.切開引流掛線術與單純切開引流術治療肛周膿腫的療效比較.中國實用外科雜志, 2012, 32(S1):15-16.
32.	周峰, 李阿莉.一期后位切開掛線左右側切開引流手術治療高位馬蹄型肛周膿腫的療效分析.中國普外基礎與臨床雜志, 2013, 20(6):655-656.
33.	陳朝暉.一期切開根治術治療肛周膿腫68例療效分析.中國肛腸病雜志, 2002, 22(5):26-27.
34.	陳朝暉, 趙自星, 吳印書.切掛花瓣樣引流根治肛周膿腫52例療效觀察.中國肛腸病雜志, 2005, 25(5):20-21.
35.	陳朝暉, 陳宏斌, 吳印書, 等. T管引流加內口擴創掛線根治高位多間隙肛周膿腫的臨床觀察.中國中西醫結合外科雜志, 2009, 15(1):33-35.
36.	胡立波, 岑嘉云, 魏立.保留括約肌術式治療高位肛周膿腫53例臨床觀察.浙江創傷外科, 2014, 4(2):236, 237.
37.	張布明, 黃偉鋒, 劉友和.一期手術治療肛周深間隙膿腫46例.中國中西醫結合外科雜志, 2013, 19(3):331-332.

1. ?國家中醫藥管理局.中醫病證診斷療效標準.南京:南京大學出版社, 1994:332.
2. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health, 1990, 13(4):227-236.
3. Kloth LC, Feedar JA. Acceleration of wound healing with high voltage, monophasic, pulsed current. Phys Ther, 1988, 68(5):503-508.
4. Jorge JM, Wexner SD. Etiology and management of faecal ineontinence. Dis Colon Rectum, 1993, 36(1):77-97.
5. 張文兵.仙方活命飲配合手術引流與外科手術治療肛周膿腫的療效比較.中國普通外科雜志, 2012, 21(8):1045-1046.
6. 袁鹿, 李春雨, 王墨飛, 等.肛周膿腫的治療.山西醫藥雜志:下半月, 2010, 39(6):505-506.
7. Macdonald A, Wilson-Storey D, Munro F. Treatment of perianal abscess and fistula-in-ano in children. Br J Surg, 2003, 90(2):220-221.
8. 章陽, 王業皇, 宗海峰, 等.丁氏痔科中位掛線改良緊線法治療高位復雜性肛瘺的臨床研究.時珍國醫國藥, 2013, 24(8):1943-1945.
9. Buddicom E, Jamieson A, Beasley S, et al. Perianal abscess in children: aiming for optimal management. ANZ J Surg, 2012, 82(1/2):60-62.
10. Murthi GV, Okoye BO, Spicer RD, et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8):689-691.
11. 王浩, 谷云飛.肛周膿腫一期治療的術式探討.局解手術學雜志, 2010, 19(4):342-343.
12. Deroide G, Deroide JP. Anal fistula and abscesses:diagnostic and therapeutic aspects, excepting Crohn's disease. J Chir (Paris), 2000, 137(2):83-92.
13. 黃潔夫.腹部外科學.北京:人民衛生出版社, 2001:1054.
14. 李二建.一次性根治術治療高位蹄鐵型膿腫的臨床觀察.中國醫藥導報, 2009, 6(32):132, 136.
15. Ezer SS, O?uzkurt P, Ince E, et al. Perianal abscess and fistula-in-ano in children:aetiology, management and outcome. J Paediatr Child Health, 2010, 46(3):92-95.
16. 張海鷹, 邱運梅, 金艷玲.保留皮橋切開根治術治療肛周膿腫臨床觀察.牡丹江醫學院學報, 2007, 28(4):67-68.
17. 王偉, 李忠卓.窗式引流掛線術治療馬蹄形肛周膿腫126例.中國實用鄉村醫生雜志, 2007, 14(3):59.
18. 李秀萍, 陳達恭, 董全進.肛旁膿腫行Ⅰ期根治性手術療效的探討.大腸肛門病外科雜志, 2005, 11(2):30.
19. 宋玉柱.一期手術根治瘺管性肛周膿腫的術式探討-附60例病例觀察.中醫藥臨床雜志, 2005, 17(4):385-386.
20. 林先強, 李勝.多切口引流術治療蹄鐵型膿腫39例.中國肛腸病雜志, 2005, 25(5):54.
21. 邵小彬.一期手術治療肛周膿腫.外科理論與實踐, 2014, 19(1):64-65.
22. 劉剛.肛周膿腫一期根治性手術的探討.天津醫學雜志, 2007, 35(5):334.
23. 阮超群, 蔣慧娟. Ⅰ期根治肛周膿腫的臨床分析.中國現代實用醫學雜志, 2008, 7(11):34-35.
24. Whiteford MH, Kilkenny J 3rd, Hyman N, et al. American Society of Colon and Rectal Surgeons. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised). Dis Colon Rectum, 2005, 48(7):1337-1342.
25. Chang SC, Lin JK. Change in anal continence after surgery for intersphincteral anal fistula:a functional and manometric study. Int J colorectal Dis, 2003, 18(2):111-115.
26. 胡伯虎, 史兆岐, 周濟民.犬肛門括約肌切開與掛線對直腸肛門管靜止壓的影響及組織病理學觀察.中醫雜志, 1983, 24(4):68-70.
27. 應文輝譯.結腸直腸疾病.昆明:云南大學出版社, 1991:209.
28. 李慶恩, 李春英.一次性切開引流掛線法治療肛周膿腫臨床對照觀察.黑龍江醫藥科學, 2013, 36(4):65.
29. 翟金榮.兩種術式治療肛周高位膿腫療效觀察.浙江中西醫結合雜志, 2007, 17(8):505-506.
30. 錢海華.保護肛腸環治療高位膿腫39例臨床觀察.長春中醫學院學報, 2003, 19(4):31-32.
31. 孫剛, 顧汝軍, 劉冬良, 等.切開引流掛線術與單純切開引流術治療肛周膿腫的療效比較.中國實用外科雜志, 2012, 32(S1):15-16.
32. 周峰, 李阿莉.一期后位切開掛線左右側切開引流手術治療高位馬蹄型肛周膿腫的療效分析.中國普外基礎與臨床雜志, 2013, 20(6):655-656.
33. 陳朝暉.一期切開根治術治療肛周膿腫68例療效分析.中國肛腸病雜志, 2002, 22(5):26-27.
34. 陳朝暉, 趙自星, 吳印書.切掛花瓣樣引流根治肛周膿腫52例療效觀察.中國肛腸病雜志, 2005, 25(5):20-21.
35. 陳朝暉, 陳宏斌, 吳印書, 等. T管引流加內口擴創掛線根治高位多間隙肛周膿腫的臨床觀察.中國中西醫結合外科雜志, 2009, 15(1):33-35.
36. 胡立波, 岑嘉云, 魏立.保留括約肌術式治療高位肛周膿腫53例臨床觀察.浙江創傷外科, 2014, 4(2):236, 237.
37. 張布明, 黃偉鋒, 劉友和.一期手術治療肛周深間隙膿腫46例.中國中西醫結合外科雜志, 2013, 19(3):331-332.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Effectiveness of Sphincter Preservation Method of Improved Minimally Invasive Surgery to Primary Cure for Horseshoe-Shaped Perianal Abscess

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