- 期刊
A Single-surgeon Experience of Treating Anal Fistulas Using the Ligation of the Intersphincteric Fistula Tract (LIFT) Procedure: Comparison between the Past and the Present
以括約肌間廔管結紮手術治療肛門廔管之單一外科醫生經驗：過去和現在之比較
摘要
Purpose. Although ligation of intersphincteric fistula tract (LIFT) procedure for anal fistula with cryptoglandular origin has increasingly gained popularity in the world, disease recurrence rates remained unsatisfactory in many institutions. We noticed that disease recurrence rates went down gradually in our hospital in recent years. Therefore, we intended to explore the reason why improving disease recurrence rates were observed in our institution. Methods. We performed a retrospective chart review to assess the surgical results of executing LIFT procedure by a single surgeon in recent 1.5 years, and made a comparison between previously published results and the present study. Results. A total of 98 LIFT procedures, which treated 5 intersphincteric fistula (5.1%), 67 low transsphincteric fistula (68.4%), 12 high transsphincteric fistula (12.3%), 14 unilateral or bilateral ischioanal fistulas (14.3%) were identified by the chart review from October 2019 to March 2021. The primary healing rate within 6 months postoperatively was 91.8%. The total recurrence rate was 8.2%, in which high transsphincteric and ischioanal type fistulas had recurrence rates of 16%. Conclusion. The present LIFT procedure in our hospital achieved good primary healing rates with comparatively low recurrence rates after we added a technical modification and increased preoperative magnetic resonance imaging use as an adjunct study for high transsphincteric and ischioanal fistula patients.
並列摘要
目的：括約肌間廔管結紮手術治療因肛門腺體感染導致的肛門廔管雖然在全世界日益受歡迎，但在許多機構中的疾病復發率仍差強人意。我們試圖找出在我們醫院裡，括約肌間廔管結紮手術的疾病復發率能夠改善的因素。方法：以回溯性研究分析最近1.5年間由單一外科醫生執行括約肌間廔管結紮手術的成果，並且與過去經驗做比較。結果：從2019年10月至2021年3月間，共有98個肛門廔管進行括約肌間廔管結紮術，其中有5個（5.1%）括約肌間型廔管，67個（68.4%）低位穿括約肌間型廔管，12個（12.3%）高位穿括約肌型廔管，14個（14.3%）單側或雙側坐骨肛門型廔管。術後6個月內初步癒合率為91.8%，總復發率為8.2%，高位穿括約肌型及坐骨肛門型廔管復發率為16%。結論：在我們對手術技巧改良以及增加術前磁振造影檢查頻率後，括約肌間廔管結紮手術對肛門廔管的治療己達到不錯的初步癒合率及相對降低的復發率。
延伸閱讀
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