[A minimally invasive approach in the treatment of complicated anal fistula through spatium intermuscular of anal sphincter].
OBJECTIVE
To investigate the optimal operative approach for the complicated anal fistula.


METHODS
One hundred and ninety-two cases with complicated anal fistula were randomly divided into minimally invasive operation group (through spatium intermuscular of anal sphincter) and fistula resection group. The operation time, bleeding time during and after operation, pain lasting time, healing time of incision, area of anal scar, anal malformation and function and post operative recurrence were observed and compared between the two groups.


RESULTS
Compared to those of fistula resection group, the operative time was (36.5+/- 15.3)min, bleeding time during and after operation (2.0+/- 0.5)d, postoperative pain lasting time (1.5+/- 0.5)d, healing time of incision (18.5+/- 5.5)d in minimally invasive operation group. All were shortened (P< 0.05), and the incidence of anal malformation (5.2%, P< 0.01) and partial anal incontinence (2.1%, P< 0.01) was lower. There was no significant difference in postoperative recurrence between the two groups.


CONCLUSIONS
The minimally invasive operation through spatium in termuscular of anal sphincter is superior to fistula resection on the management of complicated fistula.
Chen
Xiao-lan
XL
Department of Anal Colorectal Surgery, Shenzhen Second Peoples Hospital, Shenzhen 518035, China. yqzhan@sohu.com
Huang
Zhi-heng
ZH
Zhan
Yong-qiang
YQ
Liu
Min-sheng
MS
Sheng
Guang
G
Xu
Min
M
Zheng
Kai
K
Wang
Cheng-you
CY
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012003:Rectal Fistula / Q000601:surgery*; D016896:Treatment Outcome