title: [A minimally invasive approach in the treatment of complicated anal fistula through spatium intermuscular of anal sphincter].
abstract: 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.
authors.affiliation: Department of Anal Colorectal Surgery, Shenzhen Second Peoples Hospital, Shenzhen 518035, China. yqzhan@sohu.com
authors.forename: Xiao-lan
authors.initials: XL
authors.lastname: Chen
authors.forename: Zhi-heng
authors.initials: ZH
authors.lastname: Huang
authors.forename: Yong-qiang
authors.initials: YQ
authors.lastname: Zhan
authors.forename: Min-sheng
authors.initials: MS
authors.lastname: Liu
authors.forename: Guang
authors.initials: G
authors.lastname: Sheng
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.forename: Cheng-you
authors.initials: CY
authors.lastname: Wang
mesh_terms: 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