摘要
目的探讨部分瘘管切开肛瘘栓填塞在括约肌上型肛瘘手术中的应用。方法对5例患者切开括约肌外侧瘘管，保留穿过括约肌的部分瘘管，清除瘘管内坏死组织，切除内口处黏膜组织，将肛瘘栓修剪后由内口拉入瘘管，近端用2-0可吸收线缝合，固定于内括约肌并用黏膜覆盖，远端缝合固定于外括约肌。结果5例全部治愈，术后无肛瘘栓脱落，无伤口感染，肛门功能良好，随访3个月，无复发。结论部分瘘管切开肛瘘栓填塞治疗括约肌上型肛瘘对肛门括约肌无损伤，可避免脓腔残留，有助于提高手术成功率。
Objective To discuss the application of partial fistulotomy and anal fistula plug re- pair in the treatment of suprashpincteric anal fistula. Methods 5 cases have been treated. The extras- phincteric portion of the fistula was cut while the portion passing through the sphincter muscle was pre- served. The necrotic tissue in the fistula was removed,the mucosa around the internal opening was resec- ted, the anal fistula plug was pruned and pulled into the fistula from the internal opening, the proximal end of the anal fistula plug was sutured and fixed in the internal sphincter using 2-0 absorbable suture and cov- ered by the mucosa, the distal end of the anal fistula plug was sutured and fixed in the external sphincter. Results 5 patients were all cured,no extrusion of the anal fistula plug or wound infection occurred after the operation, the function of the anal was good, no recurrence occurred followed up for 3 months. Conclu- sion Preoperative assessment of high complex anal fistula should combine endoanal ultrasound with Mag- netic Resonance Imaging（MRI）. There is no damage to the anal sphincter by partial fistulotomy and anal fistula plug repair in the treatment of suprashpincteric anal fistula, the procedure can avoid the residue of pus cavity and help improving the success rate of operation.
出处
《临床外科杂志》
2015年第9期702-704,共3页
Journal of Clinical Surgery
关键词
括约肌上型肛瘘
肛瘘栓
切开术
手术
治疗
suprasphincteric anal fistula
anal fistula plug
fistulotomy
operation
treatment
