Single-surgeon Experience of Intersphincteric Fistula Tract Ligation for Anal Fistula

括約肌間廔管結紮術治療肛門廔管－單一醫師經驗分享

吳柏憲(Po-Hsien Wu) ； 饒樹文(Shu-Wen Jao) ； 溫家政(Chia-Cheng Wen) ； 陳昭仰(Chao-Yang Chen) ； 張筆凱(Pi-Kai Chang) ； 胡哲銘(Je-Ming Hu) ； 胡勝益(Sheng-I Hu) ； 張玉樺(Yu-Hua Chang) ； 江明倫(Ming-Lun Chiang) ； 鄭屹喬(Yi-Chiao Cheng)

《中華民國大腸直腸外科醫學會雜誌》 32卷3期 (2021/09) Pp. 130-138

https://doi.org/10.6312/SCRSTW.202109_32(3).11010

摘要

Purpose. Ligation of intersphincteric fistula tract is a newly developed surgery for complicated anal fistulas with the advantage of sphincter preservation. This study aimed to provide a single-surgeon experience of the ligation of intersphincteric fistula tract procedure in the management of anal fistulas. Methods. All patients who underwent the ligation of intersphincteric fistula tract procedure between December 2018 and July 2020 at the institution were included in this study. A total of 59 patients were treated with elective ligation of intersphincteric fistula tract. In this retrospective study, patient characteristics, outcomes, and complications were collected and analyzed for possible risk factors for recurrence. Results. Atotal of 59 patients was analyzed. The overall success rate was 70.6%, and the recurrence rate was 29.3% after a median follow-up time of 325.5 days. There was one case of postoperative hemorrhage and no clinically fecal incontinence. The risk factor for recurrence was the complexity of the anal fistula (p ＜ 0.005). However, body mass index, sex, operation time, wound dehiscence, and fibrin sealant use were not associated with recurrence. Conclusions. The ligation of intersphincteric fistula tract procedure is effective and safe for treating anal fistulas with acceptable healing rates and complications.

關鍵字

Ligation of intersphincteric fistula tract ； Anal fistula ； Healing rate

並列摘要

目的：括約肌間廔管結紮術為一可以保留肛門括約肌手術，多用於治療複雜性廔管，本研究提供此術式在單一醫師治療肛門廔管的早期經驗及成果。方法：自民國107年12月至109年5月，我們對59個接受括約肌間廔管結紮術的病患接受回顧性研究，探討該術式的成功率及復發率，並針對性別、身體質量指數、手術時間等因素進行分析是否會影響廔管復發 。結果：在追蹤近一年後，成功率為70.6%，而整體復發率為29.3%，術後併發症為出血（1.7%），所有病人沒有失禁的併發症產生。影響廔管的風險因子為廔管的複雜度，其他如性別、身體質量指數、手術時間、傷口崩裂，使用組織修復凝合劑對廔管復發並無關連性。結論：約肌間廔管結紮術用來治療肛門廔管是有效且安全的，手術成功率及併發症都在合理範圍內。

並列關鍵字

括約肌間廔管結紮 ； 肛門廔管 ； 癒合率

參考文獻

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