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福建医药杂志 1994年第6期16卷 94-94页

作者：吴泽炎福建医学院附属协和医院

挂线清创贯通留桥术治疗马蹄形肛瘘２０例福建医学院附属协和医院吴泽炎１９８６年以来笔者治疗马蹄形肛瘘２０例，取得了良好的疗效，现报告如下。一、一般资料２０例马蹄形肛瘘中，男性１８例，女性２例。年龄３０～５２岁；病史最长... 详细信息

挂线清创贯通留桥术治疗马蹄形肛瘘２０例福建医学院附属协和医院吴泽炎１９８６年以来笔者治疗马蹄形肛瘘２０例，取得了良好的疗效，现报告如下。一、一般资料２０例马蹄形肛瘘中，男性１８例，女性２例。年龄３０～５２岁；病史最长１０年，最短３年。前马蹄形肛瘘６例...

关键词：马蹄形肛瘘挂线术肛管直肠环肛尾韧带吴泽炎马蹄形瘘齿线皮桥直肠瘘手术适应症

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肛管内超声引导下的肛瘘手术

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 26-26页

作者： Ratto C. Grillo E. Parello A. 尹勇 Department of Surgical Sciences Catholic University Largo A. Gemelli 8 00168 Rome ItalyDr.

Background and study aims: Outcomes following surgical treatment of patients with anal fistula are related to eradication of tracts and the internal opening. In this study, the results of surgery based on endoanal ultrasound (EAUS) findings were evaluated. Patients and methods: A total of 102 patients with primary cryptogenetic anal fistula were prospectively examined with EAUS, using a 360-degree rotating 10-MHz probe, equipped with a three-dimensional (3-D) imaging system. Injection of hydrogen peroxide through the external opening was also used. Patients underwent operation on the basis of the EAUS findings. The agreement between findings from EAUS and from surgery was calculated. Clinical results were reported as treatment success, fistula recurrence, and fecal incontinence. Results: Amongst 102 patients, the overall concordance between EAUS and surgical findings was 94.1% for primary tracts, 91.2% for internal openings, 96.1% for secondary tracts, 100% for abscesses, and 96.1% for horseshoe tracts. Diagnostic accuracy was improved when hydrogen peroxide injection or 3-D imaging were used. Fistulotomy was performed in 46 patients (45.1% ), fistulectomy in 17 (16.7% ), fistulotomy plus seton placement in 19 (18.6% ), fistulectomy plus seton in 18 (17.6% ), and mucosal flap advancement in 2 (2.0% ). The operation was curative in 100 patients (98.0% ), and unsuccessful in 2 (2.0% ) due to recurrence of the fistula. Fecal continence was preserved in all patients. Conclusions: These data highlight the diagnostic accuracy of EAUS, particularly when hydrogen peroxide injection or 3-D imaging are used. Basing our surgical decision making on EAUS findings allowed us to carry out curative operations in a significantly large number of patients; the recurrence rate was very low. The accurate EAUS assessment of the relationship between fistulas and sphincters has been the main factor in choosing a sphincter-saving surgical procedure, avoiding fecal incontinence.

关键词：肛瘘手术肛管内超声马蹄形瘘瘘管切开术挂线术肛周脓肿大便失禁瘘管切除术黏膜瓣复发率

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