目的探究改良括约肌间瘘管结扎术(Lift-plug)在经括约肌肛瘘(TSAF)病人治疗中的应用优势。方法回顾性收集2020年3月至2022年3月首都医科大学附属北京潞河医院110例TSAF病人临床资料,根据手术方法分为两组,传统组55例行Lift,Lift-plug组5...目的探究改良括约肌间瘘管结扎术(Lift-plug)在经括约肌肛瘘(TSAF)病人治疗中的应用优势。方法回顾性收集2020年3月至2022年3月首都医科大学附属北京潞河医院110例TSAF病人临床资料,根据手术方法分为两组,传统组55例行Lift,Lift-plug组55例行Lift-plug术。比较两组围术期指标、临床疗效、并发症、复发率及神经源性炎症因子[P物质(SP)、神经生长因子(NGF)、前列腺素E_(2)(PGE_(2))]、肠道微生态[D-乳酸、二胺氧化酶(DAO)]、肛门括约肌功能(肛门功能指数评分、Wexner尿失禁评分)。结果Lift-plug组手术时间[(20.22±3.34)min比(23.89±4.11)min]、创面愈合时间[(25.50±3.38)d比(30.31±4.56)d]、住院时间[(5.88±0.82)d比(6.42±1.03)d]短于传统组,术后1 d VAS评分[(2.41±0.35)分比(3.02±0.42)分]低于传统组(P<0.05);术后1 d Lift-plug组血清SP、NGF、PGE_(2)水平低于传统组(P<0.05);术后1 d、3 d两组D-乳酸、血浆DAO水平均差异无统计学意义(P>0.05);术后1个月、3个月Lift-plug组肛门功能指数、Wexner尿失禁评分均低于传统组(P<0.05);术后3个月,Lift-plug组治疗总有效率高于传统组(P<0.05);术后3个月两组并发症发生率及复发率比较差异无统计学意义(P>0.05)。结论Lift-plug术治疗TSAF病人可优化手术,减轻神经源性炎症反应,减轻早期疼痛,改善括约肌功能,增强临床疗效,且具有较高安全性。展开更多
Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital. A two-sided prosthesis piece bent in the ...Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital. A two-sided prosthesis piece bent in the shape of a cone is used here as an anal plug. The aim of this work was to evaluate the therapeutic results and the safety of this device. Patients and Methods: The clinical data of patients operated by the LIFT-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively. The variables evaluated were operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was 1.15. No patient presented preoperative continence disorder. The fistula was high trans-sphincteric in 89.3% of cases. The average duration of surgery was 55.2 minutes (45 to 66 minutes). The postoperative course was straightforward, although 60.7% of the patients had experienced tingling that resolved spontaneously. Three patients (10.7%) presented with transient gas incontinence (WIS of 4) which completely resolved after one month. All patients healed within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective technique for the treatment of upper anal fistula without major impairment of continence despite delayed healing. The adapted two-sided prosthesis is a good alternative to the conventional anal plug.展开更多
文摘目的探究改良括约肌间瘘管结扎术(Lift-plug)在经括约肌肛瘘(TSAF)病人治疗中的应用优势。方法回顾性收集2020年3月至2022年3月首都医科大学附属北京潞河医院110例TSAF病人临床资料,根据手术方法分为两组,传统组55例行Lift,Lift-plug组55例行Lift-plug术。比较两组围术期指标、临床疗效、并发症、复发率及神经源性炎症因子[P物质(SP)、神经生长因子(NGF)、前列腺素E_(2)(PGE_(2))]、肠道微生态[D-乳酸、二胺氧化酶(DAO)]、肛门括约肌功能(肛门功能指数评分、Wexner尿失禁评分)。结果Lift-plug组手术时间[(20.22±3.34)min比(23.89±4.11)min]、创面愈合时间[(25.50±3.38)d比(30.31±4.56)d]、住院时间[(5.88±0.82)d比(6.42±1.03)d]短于传统组,术后1 d VAS评分[(2.41±0.35)分比(3.02±0.42)分]低于传统组(P<0.05);术后1 d Lift-plug组血清SP、NGF、PGE_(2)水平低于传统组(P<0.05);术后1 d、3 d两组D-乳酸、血浆DAO水平均差异无统计学意义(P>0.05);术后1个月、3个月Lift-plug组肛门功能指数、Wexner尿失禁评分均低于传统组(P<0.05);术后3个月,Lift-plug组治疗总有效率高于传统组(P<0.05);术后3个月两组并发症发生率及复发率比较差异无统计学意义(P>0.05)。结论Lift-plug术治疗TSAF病人可优化手术,减轻神经源性炎症反应,减轻早期疼痛,改善括约肌功能,增强临床疗效,且具有较高安全性。
文摘Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital. A two-sided prosthesis piece bent in the shape of a cone is used here as an anal plug. The aim of this work was to evaluate the therapeutic results and the safety of this device. Patients and Methods: The clinical data of patients operated by the LIFT-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively. The variables evaluated were operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was 1.15. No patient presented preoperative continence disorder. The fistula was high trans-sphincteric in 89.3% of cases. The average duration of surgery was 55.2 minutes (45 to 66 minutes). The postoperative course was straightforward, although 60.7% of the patients had experienced tingling that resolved spontaneously. Three patients (10.7%) presented with transient gas incontinence (WIS of 4) which completely resolved after one month. All patients healed within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective technique for the treatment of upper anal fistula without major impairment of continence despite delayed healing. The adapted two-sided prosthesis is a good alternative to the conventional anal plug.
