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.	国家中医药管理局.中医病证诊断疗效标准.南京:南京大学出版社, 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.	张文兵.仙方活命饮配合手术引流与外科手术治疗肛周脓肿的疗效比较.中国普通外科杂志, 2012, 21(8):1045-1046.
6.	袁鹿, 李春雨, 王墨飞, 等.肛周脓肿的治疗.山西医药杂志: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.	章阳, 王业皇, 宗海峰, 等.丁氏痔科中位挂线改良紧线法治疗高位复杂性肛瘘的临床研究.时珍国医国药, 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, 谷云飞.肛周脓肿一期治疗的术式探讨.局解手术学杂志, 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.	黄洁夫.腹部外科学.北京:人民卫生出版社, 2001:1054.
14.	李二建.一次性根治术治疗高位蹄铁型脓肿的临床观察.中国医药导报, 2009, 6(32):132, 136.
15.	Ezer SS, Oğuzkurt 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.	张海鹰, 邱运梅, 金艳玲.保留皮桥切开根治术治疗肛周脓肿临床观察.牡丹江医学院学报, 2007, 28(4):67-68.
17.	王伟, 李忠卓.窗式引流挂线术治疗马蹄形肛周脓肿126例.中国实用乡村医生杂志, 2007, 14(3):59.
18.	李秀萍, 陈达恭, 董全进.肛旁脓肿行Ⅰ期根治性手术疗效的探讨.大肠肛门病外科杂志, 2005, 11(2):30.
19.	宋玉柱.一期手术根治瘘管性肛周脓肿的术式探讨-附60例病例观察.中医药临床杂志, 2005, 17(4):385-386.
20.	林先强, 李胜.多切口引流术治疗蹄铁型脓肿39例.中国肛肠病杂志, 2005, 25(5):54.
21.	邵小彬.一期手术治疗肛周脓肿.外科理论与实践, 2014, 19(1):64-65.
22.	刘刚.肛周脓肿一期根治性手术的探讨.天津医学杂志, 2007, 35(5):334.
23.	阮超群, 蒋慧娟. Ⅰ期根治肛周脓肿的临床分析.中国现代实用医学杂志, 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, 周济民.犬肛门括约肌切开与挂线对直肠肛门管静止压的影响及组织病理学观察.中医杂志, 1983, 24(4):68-70.
27.	应文辉译.结肠直肠疾病.昆明:云南大学出版社, 1991:209.
28.	李庆恩, 李春英.一次性切开引流挂线法治疗肛周脓肿临床对照观察.黑龙江医药科学, 2013, 36(4):65.
29.	翟金荣.两种术式治疗肛周高位脓肿疗效观察.浙江中西医结合杂志, 2007, 17(8):505-506.
30.	钱海华.保护肛肠环治疗高位脓肿39例临床观察.长春中医学院学报, 2003, 19(4):31-32.
31.	孙刚, 顾汝军, 刘冬良, 等.切开引流挂线术与单纯切开引流术治疗肛周脓肿的疗效比较.中国实用外科杂志, 2012, 32(S1):15-16.
32.	周峰, 李阿莉.一期后位切开挂线左右侧切开引流手术治疗高位马蹄型肛周脓肿的疗效分析.中国普外基础与临床杂志, 2013, 20(6):655-656.
33.	陈朝晖.一期切开根治术治疗肛周脓肿68例疗效分析.中国肛肠病杂志, 2002, 22(5):26-27.
34.	陈朝晖, 赵自星, 吴印书.切挂花瓣样引流根治肛周脓肿52例疗效观察.中国肛肠病杂志, 2005, 25(5):20-21.
35.	陈朝晖, 陈宏斌, 吴印书, 等. T管引流加内口扩创挂线根治高位多间隙肛周脓肿的临床观察.中国中西医结合外科杂志, 2009, 15(1):33-35.
36.	胡立波, 岑嘉云, 魏立.保留括约肌术式治疗高位肛周脓肿53例临床观察.浙江创伤外科, 2014, 4(2):236, 237.
37.	张布明, 黄伟锋, 刘友和.一期手术治疗肛周深间隙脓肿46例.中国中西医结合外科杂志, 2013, 19(3):331-332.

1. 国家中医药管理局.中医病证诊断疗效标准.南京:南京大学出版社, 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. 张文兵.仙方活命饮配合手术引流与外科手术治疗肛周脓肿的疗效比较.中国普通外科杂志, 2012, 21(8):1045-1046.
6. 袁鹿, 李春雨, 王墨飞, 等.肛周脓肿的治疗.山西医药杂志: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. 章阳, 王业皇, 宗海峰, 等.丁氏痔科中位挂线改良紧线法治疗高位复杂性肛瘘的临床研究.时珍国医国药, 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, 谷云飞.肛周脓肿一期治疗的术式探讨.局解手术学杂志, 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. 黄洁夫.腹部外科学.北京:人民卫生出版社, 2001:1054.
14. 李二建.一次性根治术治疗高位蹄铁型脓肿的临床观察.中国医药导报, 2009, 6(32):132, 136.
15. Ezer SS, Oğuzkurt 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. 张海鹰, 邱运梅, 金艳玲.保留皮桥切开根治术治疗肛周脓肿临床观察.牡丹江医学院学报, 2007, 28(4):67-68.
17. 王伟, 李忠卓.窗式引流挂线术治疗马蹄形肛周脓肿126例.中国实用乡村医生杂志, 2007, 14(3):59.
18. 李秀萍, 陈达恭, 董全进.肛旁脓肿行Ⅰ期根治性手术疗效的探讨.大肠肛门病外科杂志, 2005, 11(2):30.
19. 宋玉柱.一期手术根治瘘管性肛周脓肿的术式探讨-附60例病例观察.中医药临床杂志, 2005, 17(4):385-386.
20. 林先强, 李胜.多切口引流术治疗蹄铁型脓肿39例.中国肛肠病杂志, 2005, 25(5):54.
21. 邵小彬.一期手术治疗肛周脓肿.外科理论与实践, 2014, 19(1):64-65.
22. 刘刚.肛周脓肿一期根治性手术的探讨.天津医学杂志, 2007, 35(5):334.
23. 阮超群, 蒋慧娟. Ⅰ期根治肛周脓肿的临床分析.中国现代实用医学杂志, 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, 周济民.犬肛门括约肌切开与挂线对直肠肛门管静止压的影响及组织病理学观察.中医杂志, 1983, 24(4):68-70.
27. 应文辉译.结肠直肠疾病.昆明:云南大学出版社, 1991:209.
28. 李庆恩, 李春英.一次性切开引流挂线法治疗肛周脓肿临床对照观察.黑龙江医药科学, 2013, 36(4):65.
29. 翟金荣.两种术式治疗肛周高位脓肿疗效观察.浙江中西医结合杂志, 2007, 17(8):505-506.
30. 钱海华.保护肛肠环治疗高位脓肿39例临床观察.长春中医学院学报, 2003, 19(4):31-32.
31. 孙刚, 顾汝军, 刘冬良, 等.切开引流挂线术与单纯切开引流术治疗肛周脓肿的疗效比较.中国实用外科杂志, 2012, 32(S1):15-16.
32. 周峰, 李阿莉.一期后位切开挂线左右侧切开引流手术治疗高位马蹄型肛周脓肿的疗效分析.中国普外基础与临床杂志, 2013, 20(6):655-656.
33. 陈朝晖.一期切开根治术治疗肛周脓肿68例疗效分析.中国肛肠病杂志, 2002, 22(5):26-27.
34. 陈朝晖, 赵自星, 吴印书.切挂花瓣样引流根治肛周脓肿52例疗效观察.中国肛肠病杂志, 2005, 25(5):20-21.
35. 陈朝晖, 陈宏斌, 吴印书, 等. T管引流加内口扩创挂线根治高位多间隙肛周脓肿的临床观察.中国中西医结合外科杂志, 2009, 15(1):33-35.
36. 胡立波, 岑嘉云, 魏立.保留括约肌术式治疗高位肛周脓肿53例临床观察.浙江创伤外科, 2014, 4(2):236, 237.
37. 张布明, 黄伟锋, 刘友和.一期手术治疗肛周深间隙脓肿46例.中国中西医结合外科杂志, 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

Abstract Full text Figures/Tables Video References Cited by

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