Hüseyin Uzun, Yalçin Burak Kara, Mehmet Eser, Levent Kaptanoğlu, Metin Kement
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引用次数: 0
Abstract
Aim: This study aims to compare the clinical outcomes of patients treated for complex anal fistulas using standard laser fistula closure (FiLaC) versus FiLaC combined with an advancement flap (+FLAP).
Methods: A retrospective review was conducted on patients treated for complex anal fistulas between January 2022 and December 2023. Treatments included standard FiLaC and FiLaC combined with an advancement flap. Main outcome measures included operation duration, hospital stay, postoperative pain [Visual Analog Scale (VAS) score], complications, and success rate.
Results: A total of 47 patients were included in the study, with 25 in the standard FiLaC group and 22 in the +FLAP group. The +FLAP group had significantly longer operation times (29.7 ± 4.7 min versus 18.7 ± 4.0 min, p < 0.001) and hospital stays (16.2 ± 5.04 h versus 3.9 ± 2.3 h p < 0.001). Postoperative pain scores were similar between groups. The mean follow-up periods for the FILAC and +FLAP groups were 10.5 ± 3.5 months and 8.4 ± 4.0 months, respectively. The success rate was significantly higher in the +FLAP group (95.5% versus 72%, p = 0.03).
Conclusion: In this study, we found that, compared with FiLAC alone, combining FiLaC with an advancement flap may significantly improve primary success rates in the treatment of complex anal fistulas, and we believe this approach could be a valuable option for enhancing treatment outcomes in complex cases. The increased operation and hospital stay durations appear to be balanced by the higher success rates.
目的：本研究旨在比较使用标准激光瘘管闭合术（FiLaC）与FiLaC联合推进皮瓣（+ flap）治疗复杂肛瘘的临床效果。方法：回顾性分析2022年1月至2023年12月收治的复杂肛瘘患者。治疗包括标准的FiLaC和FiLaC联合推进皮瓣。主要观察指标包括手术时间、住院时间、术后疼痛[视觉模拟评分（VAS）]、并发症和成功率。结果：共纳入47例患者，其中标准FiLaC组25例，+FLAP组22例。+FLAP组的手术时间明显延长（29.7±4.7 min vs 18.7±4.0 min）， p结论：本研究中，我们发现，与单独使用FiLAC相比，FiLAC联合推进皮瓣可以显著提高复杂肛瘘治疗的原发性成功率，我们认为这种方法可能是提高复杂病例治疗效果的有价值的选择。手术时间和住院时间的增加似乎与成功率的提高相平衡。
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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