一种新型保留括约肌术式：激光瘘管闭合术治疗复杂性肛瘘_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

杨勇 , 张正国 ,  杨光

徐州市中心医院肛肠科（江苏徐州 221009）;

Corresponding author：

杨光, Email: 362939833@qq.com

Keywords：

激光瘘管闭合术; 保留括约肌术式; 复杂性肛瘘

DOI：

10.7507/1007-9424.201704108

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的初步探讨激光瘘管闭合术治疗复杂性肛瘘的临床疗效。方法回顾性分析 2016 年 8 月至 2017 年 3 月期间笔者所在医院科室行激光瘘管闭合术治疗的复杂性肛瘘 5 例患者的临床资料。结果 5 例患者术后一期愈合 4 例；另1 例于术后 5 d 失败，于局麻下自括约肌间沟切开内口部分，外口至括约肌间瘘管挂皮筋引流，15 d 后拆除引流皮筋，22 d 后愈合。5 例患者平均手术时间为 10 min，术中均无明显出血和括约肌损伤。肛门疼痛视觉模拟评分术后第 3 天平均为 3.8 分，第 5 天平均为 1.6 分。术后平均住院时间为 8.5 d。术后平均随访 8 个月（3～11 个月）无复发，无并发症及肛门失禁发生。结论从本研究的数据初步得出，激光瘘管闭合术治疗复杂性肛瘘安全、有效，完全保留了括约肌，术后疼痛轻，恢复快，对肛门功能保护较好。

Citation： 杨勇, 张正国, 杨光. 一种新型保留括约肌术式：激光瘘管闭合术治疗复杂性肛瘘. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1384-1386. doi: 10.7507/1007-9424.201704108 Copy

1.	任东林, 张恒. 复杂性肛瘘诊治中需要注意的几个关键问题. 中华胃肠外科杂志, 2015, 18(12): 1186-1192.
2.	Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
3.	Woodforde JM, Merskey H. Some relationships between subjective measures of pain. J Psychosom Res, 1972, 16(3): 173-178.
4.	Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum, 1993, 36(1): 77-97.
5.	Vogel JD, Johnson EK, Morris AM, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum, 2016, 59(12): 1117-1133.
6.	曾宪东, 张勇. 肛瘘的外科治疗. 中华胃肠外科杂志, 2014, 17(12): 1164-1166.
7.	陈豪, 冷强, 金黑鹰, 等. 国内外肛瘘诊疗现状的对比与启示. 世界华人消化杂志, 2016, 24(6): 978-982.
8.	Slutzki S, Abramsohn R, Bogokowsky H. Carbon dioxide laser in the treatment of high anal fistula. Am J Surg, 1981, 141(3): 395-396.
9.	Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science, 1983, 220(4596): 524-527.
10.	Giamundo P, Geraci M, Tibaldi L, et al. Closure of fistula-in-ano with laser—FiLaC^TM: an effective novel sphincter-saving procedure for complex disease. Colorectal Dis, 2014, 16(2): 110-115.
11.	Giamundo P, Esercizio L, Geraci M, et al. Fistula-tract Laser Closure (FiLaC^TM): long-term results and new operative strategies. Tech Coloproctol, 2015, 19(8): 449-453.
12.	Oztürk E, Gülcü B. Laser ablation of fistula tract: a sphincter-preserving method for treating fistula-in-ano. Dis Colon Rectum, 2014, 57(3): 360-364.
13.	Wilhelm A, Fiebig A, Krawczak M. Five years of experience with the FiLaC^TM laser for fistula-in-ano management: long-term follow-up from a single institution. Tech Coloproctol, 2017, 21(4): 269-276.
14.	Ommer A, Herold A, Berg E, et al. German S3 guidelines: anal abscess and fistula (second revised version). Langenbecks Arch Surg, 2017, 402(2): 191-201.
15.	杨勇, 张正国, 杨光. 激光瘘管闭合术治疗肛瘘一例. 中华结直肠电子杂志, 2017, 6(3): 255-256.

1. 任东林, 张恒. 复杂性肛瘘诊治中需要注意的几个关键问题. 中华胃肠外科杂志, 2015, 18(12): 1186-1192.
2. Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
3. Woodforde JM, Merskey H. Some relationships between subjective measures of pain. J Psychosom Res, 1972, 16(3): 173-178.
4. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum, 1993, 36(1): 77-97.
5. Vogel JD, Johnson EK, Morris AM, et al. Clinical practice guideline for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum, 2016, 59(12): 1117-1133.
6. 曾宪东, 张勇. 肛瘘的外科治疗. 中华胃肠外科杂志, 2014, 17(12): 1164-1166.
7. 陈豪, 冷强, 金黑鹰, 等. 国内外肛瘘诊疗现状的对比与启示. 世界华人消化杂志, 2016, 24(6): 978-982.
8. Slutzki S, Abramsohn R, Bogokowsky H. Carbon dioxide laser in the treatment of high anal fistula. Am J Surg, 1981, 141(3): 395-396.
9. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science, 1983, 220(4596): 524-527.
10. Giamundo P, Geraci M, Tibaldi L, et al. Closure of fistula-in-ano with laser—FiLaC^TM: an effective novel sphincter-saving procedure for complex disease. Colorectal Dis, 2014, 16(2): 110-115.
11. Giamundo P, Esercizio L, Geraci M, et al. Fistula-tract Laser Closure (FiLaC^TM): long-term results and new operative strategies. Tech Coloproctol, 2015, 19(8): 449-453.
12. Oztürk E, Gülcü B. Laser ablation of fistula tract: a sphincter-preserving method for treating fistula-in-ano. Dis Colon Rectum, 2014, 57(3): 360-364.
13. Wilhelm A, Fiebig A, Krawczak M. Five years of experience with the FiLaC^TM laser for fistula-in-ano management: long-term follow-up from a single institution. Tech Coloproctol, 2017, 21(4): 269-276.
14. Ommer A, Herold A, Berg E, et al. German S3 guidelines: anal abscess and fistula (second revised version). Langenbecks Arch Surg, 2017, 402(2): 191-201.
15. 杨勇, 张正国, 杨光. 激光瘘管闭合术治疗肛瘘一例. 中华结直肠电子杂志, 2017, 6(3): 255-256.

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