肛瘺診治進展ppt課件(編輯修改稿)
2025-05-30 03:31 本頁面
【文章內容簡介】 hieved in small studies. 2. Guideline: Complex anal fistulas may be treated with endorectal advancement flap closure. ? The use of an endorectal advancement flap is an attractive modality for the treatment of a plex fistulainano. ? Successful healing rate : 55 to 98 percent of patients. Although the sphincter mechanism is not divided during the construction of an endorectal advancement flap, minor incontinence has been reported in up to 31 percent of the patients and major incontinence in up to 12 percent. ? Predictors of poor oute ： undrained sepsis, cancer or radiation etiology, rectovaginal fistula diameter cm, fistula present fewer than 6 weeks, and active Crohn’s proctitis. 3. Guideline: Complex fistulas may be treated by the use of a seton and/or staged fistulotomy: Setons may be used to induce perisphincteric fibrosis along the fistula track so that when the fistulotomy is eventually performed, or the seton gradually tightened, the muscular defect and amount of incontinence is limited. A seton may also be utilized to facilitate staged fistulotomy. The seton is used to mark the external sphincter for later division after the subcutaneous ponents have healed. Although these two techniques have low recurrence rates (0–8 percent), the rates for minor (34–63 percent) and major incontinence (2–26 percent) are significant. 關于高位復雜性肛瘺掛線的探討 ?? 高位肛瘺是否需要掛線 由于現代解剖學肛瘺切除的廣泛開展，除術中處理病變較徹底外，對肌肉的保護亦十分明確，對內口的尋找及處理亦更準確，再加上對
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