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Management of low transsphincteric anal fistula with serial setons and interval muscle-cutting fistulotomy

查看全文 作  者:Chen [1,2]Wang;Lester [1]Rosen 高影响力作者 机构地区:[1]Department of Colorectal Surgery,Cleveland Clinic Florida Weston,FL 33331,USA;[2]Department of Anorectal Surgery Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China高影响力机构 出  处:《Journal of Integrative Medicine》索引2016年第14卷第2期,共5页高影响力期刊 摘  要:This study evaluates low transsphincteric anal fistula managed by serial setons and interval fistulotomy, with attention to healing without recurrence and preservation of continence. Following Institutional Review Board approval, consecutive anal fistula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to follow up. Of the 71 patients, 26(37%) had low transsphincteric fistula(23 males and 3 females; mean age: 46 years), treated at our institution by seton placement followed by interval surgical muscle cutting and subsequent seton replacement or final fistulotomy. Of the 26 patients, 22(85%) were initially referred due to previous failed treatment, with a 30.6 month mean duration of fistula prior to referral and a mean of 2.2(range: 0–6) prior anorectal surgeries. At a mean follow-up of 11.9 months, none of the 21 patients experienced recurrence or fecal incontinence. Serial seton with interval muscle-cutting sphincterotomy followed by complete fistulotomy is an effective treatment for the management of patients who are either initially seen for low transsphincteric fistula, or referred after failed anorectal surgery for that condition. 关 键 词:串口管理 括约肌 肌肉 手术失败 切割 平均年龄 电子病历 患者
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