Clinical efficacy of modified TROPIS seton procedure in treating high anal fistula
[Objectives] To investigate the clinical efficacy of modified TROPIS seton procedure in treating high anal fistula. [Methods] A total of 167 patients with high anal fistula admitted to the Proctology Department of our hospital from January 2020 to March 2021 were selected. Patients were divided into...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2023-12-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=170&cateName=2023%E5%B9%B4%20%E7%AC%AC29%E5%8D%B7%20%E7%AC%AC6%E6%9C%9F |
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| Summary: | [Objectives] To investigate the clinical efficacy of modified TROPIS seton procedure in treating high anal fistula. [Methods] A total of 167 patients with high anal fistula admitted to the Proctology Department of our hospital from January 2020 to March 2021 were selected. Patients were divided into TROPIS seton group (n＝76) and incision-seton group (n＝91) based on the surgical methods employed. Comparative analyses were conducted on postoperative indicators, anal function, quality of life, postoperative anal pain, postoperative complications, clinical efficacy and postoperative recurrence between the two groups. [Results] The modified TROPIS seton group exhibited shorter operation time, pus shedding time, and wound healing time compared to the incision-seton group, with a smaller scar area (P<0.001). Preoperatively, no significant difference existed in Wexner anal incontinence scores between the two groups (P>0.05). However, three months postoperatively, the Wexner incontinence score in the modified TROPIS seton group was significantly lower than that in the incision-seton group (P<0.05). Similarly, preoperatively, there was no significant difference in QLAF-QS scores between the two groups (P>0.05). Three months after surgery, the QLAF-QS score of both groups was lower than before surgery, and the QLAF-QS score of the modified TROPIS seton group was lower than that of the incision-seton group (P<0.05). On the first day after surgery, there was no significant difference in VAS scores between the two groups (P>0.05). However, by the 7th day after surgery, both groups showed a decrease in VAS scores, with the modified TROPIS seton group having significantly lower scores than the incision-seton group (P<0.05). One month after surgery, the total complication rate of modified TROPIS seton group was significantly lower than that of the incision-seton group (P<0.05). The total effective rate of the modified TROPIS seton group was 97.4% (74/76), and that of the incision-seton group was 92.3% (84/91). No significant difference was observed between the two groups (P>0.05). One year after surgery, recurrence was noted in 8 patients (8.8%) from the incision-seton group and 5 patients (6.6%) from the modified TROPIS seton group. Statistical analysis revealed no significant difference in the recurrence rate between the two groups (χ2＝0.282，P＝0.595). [Conclusion] Compared with incision-seton procedure, the modified TROPIS seton procedure for treating high complex anal fistulas can shorten the operation and wound healing time, reduce scar area, decrase early postoperative anal pain, and reduce postoperative complications. The clinical efficacy and recurrence rate are found to be similar between the two procedures. |
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| ISSN: | 1674-0491 |