Comparison of the Efficacy of Laser and Hybrid Seton Methods in the Treatment of Perianal Fistula.

Ali Kemal Taskin, Mustafa Akar, Bulent Ozcetin
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Abstract

Objective: To compare the efficacy and postoperative complications of laser and hybrid seton methods in the treatment of perianal fistula (PF).

Study design: A descriptive cross-sectional study. Place and Duration of the Study: Department of General Surgery, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkiye, from January 2021 to April 2022.

Methodology: A total of 76 patients, with 46 in the hybrid seton group and 30 in the laser group, were included in the study. Perianal fistula classification was based on preoperative magnetic resonance imaging. The Likert satisfaction scale was assessed for patient satisfaction and the Cleveland Clinic Florida Faecal Incontinence (CCF-FI) scoring system was used for incontinence. Treatment outcome was determined based on success rate and postoperative faecal incontinence.

Results: The mean age of the patients was 43 ± 13 years and 59 (78%) of them were male. Forty-seven (62%) patients had simple fistula. Acute and late complications were significantly higher in the hybrid seton group than in the laser group (p <0.001). According to the Likert satisfaction scale, the rate of unsatisfied patients was significantly higher in the laser group than in the hybrid seton group (p = 0.02). According to the CCF-FI scoring system, incontinence was significantly higher in the hybrid seton group than in the laser group (p = 0.01). Treatment failure was higher in the laser group (p = 0.03).

Conclusion: The laser method has lower intraoperative / postoperative complications, but higher treatment failure and lower patient satisfaction compared to the hybrid seton method.

Key words: Anal fistula, Fecal incontinence, Laser therapy, Outcome, Loose seton method.

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激光和混合塞通法在治疗肛周瘘中的疗效比较。
研究目的比较激光和混合型套扎法治疗肛周瘘的疗效和术后并发症:描述性横断面研究。研究地点和时间:研究地点和时间:土耳其布尔萨尤克赛克-伊赫蒂萨斯培训与研究医院健康科学大学普通外科,2021年1月至2022年4月:研究共纳入 76 名患者,其中混合套管组 46 人,激光组 30 人。根据术前磁共振成像对肛周瘘进行分类。患者满意度采用李克特满意度量表,尿失禁采用克利夫兰诊所佛罗里达尿失禁(CCF-FI)评分系统。治疗结果根据成功率和术后大便失禁情况确定:患者的平均年龄为 43 ± 13 岁,其中 59 人(78%)为男性。47例(62%)患者为单纯性瘘管。混合型套管组的急性和晚期并发症明显高于激光组(P 结论:混合型套管组的术中并发症明显低于激光组:激光法的术中、术后并发症较低,但治疗失败率较高,患者满意度较低:肛瘘 大便失禁 激光治疗 效果 松套法
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