ObjectiveTo investigate effect of preoperative three-dimensional anorectal endosonography (3D-AREUS) in anal fistula surgery.MethodsA total of 100 patients with anal fistula who were admitted to the Chaoyang Central Hospital from December 2017 to December 2018 were included prospectively, then were randomly divided into ultrasound group and control group with 50 cases in each group. The preoperative examination was performed by 3D-AREUS in the ultrasound group, and preoperative routine examination, finger examination or probe exploration were performed in the control group. The postoperative recurrence and anal functions were compared between the two groups.ResultsThere were no statistically significant differences in the gender, age, body mass index, anal surgery history, preoperative anal function, etc. between the two groups (P>0.05). The detection rate of branch fistulas in the ultrasound group was significantly higher than that in the control group (P=0.025). For the patients with complex anal fistula, compared with the control group, the location accuracy rate of internal opening was higher (P=0.014), the change value of preoperative and postoperative fecal incontinence score was lower (P=0.039), anorectal pressure status (resting pressure of anal canal, anal systolic pressure, and length of anal high pressure zone) were lower (P<0.05) in the ultrasound group; For the patients with simple anal fistula, which had no significant differences between the ultrasound group and control group (P>0.05). There were 4 cases of recurrence in each group.ConclusionsFor complex anal fistula, preoperative 3D-AREUS could clarify position of internal opening, presence of branching fistula, and the relationship between fistula and sphincter, so as to make accurate surgical plans, reduce secondary injuries, and retain postoperative anal function of patients.
ObjectiveTo summarize the current commonly used anal function assessment methods after anorectal preservation surgery, and to discuss the current status of research and existing problems of anal function in patients after transanal total mesorectal excision (taTME) surgery.MethodBy searching the relevant literatures in domestic and international databases, the studies on anal function of patients after taTME and the studies on anal function assessment tools after anorectal preservation surgery were included to make an review.ResultsThere was little literatures on the recovery of anal function after taTME, especially the long-term recovery of anal function after taTME was still unclear. The anal function in the early stage after traditional anal preserving operation for rectal cancer may be superior to taTME, but the recovery of anal function in the middle and long term after operation was similar. In terms of research tools, most of the current studies tend to use scale assessment method to describe the recovery of anal function after taTME, while the objective quantitative index, such as anorectal manometry and anal ultrasound were rarely used.ConclusionAt present, there is a single and inconsistent research tool for the study of postoperative anal function after taTME, so further research is still needed to provide data reference for the postoperative anal function recovery curve of rectal cancer patients.