Parks改良虚挂线配合TROPIS术治疗高位括约肌间肛瘘的疗效观察

doi:10.3969/j.issn.1006-6233.2025.01.024

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Abstract Objective: To investigate the effect of Parks modified virtual hanging line combined with transanal sphincterotomy (TROPIS) in patients with high sphincteroanal fistula. Methods: A total of 92 patients with high intersphincter anal fistula admitted to 901 Hospital from February 2021 to October 2023 were selected and divided into two groups, with 46 cases in each group by random number table method. The control group was treated with incision and hanging line, and the observation group was treated with Parks modified virtual hanging line and TROPIS. The postoperative indexes, pain and wound healing, complications, recurrence rate, inflammatory stress [interleukin-1 (IL-1), myeloperoxidase (MPO), interleukin-6 (IL-6)], sphincter function and local wound microenvironment were compared between the two groups. Results: The intraoperative bleeding volume in the observation group was (8.32±2.17) mL, which was lower than that in the control group (21.46±4.76) mL. The time for surgery and edema resolution, wound exudate disappearance, and complete wound healing in the observation group were (35.57±6.59) min, (5.12±1.38) d, (6.24±1.96) d, and (16.52±2.74) d, respectively, which were lower than in the control group (48.26±8.17) min, (6.53±1.47) d, (7.38±1.63) d, and (18.27±3.51) d, respectively, with a P value lower than 0.05. At 1 day, 3 days, 7 days, and 14 days after surgery, the pain score in the observation group was (4.14±0.63)d, (3.02±0.51)d, (1.84±0.53)d, and (0.82±0.29)d, which was lower than the control group at (5.35±0.56)d, (5.35±0.56)d, (3.16±0.87)d, and (1.97±0.35)d, with a P value lower than 0.05. The wound healing in the observation group was better than in the control group at 7 and 14 days after operation (P<0.05). The levels of serum MPO, IL-1 and IL-6 in the observation group were lower than in the control group at 1, 3 and 7 days after surgery (P<0.05). After 7 days of surgery, the proportion of Firmicutes in the observation group was (86.35±3.69)%, higher than that of the control group at(74.18±4.54)%. The proportion of Proteobacteria and Actinobacteria was (7.25±1.00)% and (1.87±0.24)%, respectively, lower than the control group at (16.37±1.36)% and (2.65±0.32)%, respectively, (P<0.05). The Wexner incontinence score of the observation group was lower than that of the control group, and the resting pressure and maximum systolic pressure of the anal canal were higher than those of the control group (P<0.05). The complication rate of observation group was 8.70%, lower than that of control group (23.91%) (P<0.05). After 6 months of follow-up, the recurrence rate of observation group was 2.17% compared with 10.87% in control group, and there was no significant difference (P>0.05). Conclusion: Parks modified virtual hanging line combined with TROPIS can alleviate sphincter injury, reduce inflammatory stress and complication risk, maintain local wound microenvironment, and accelerate postoperative rehabilitation.

Key words： Intersphincter anal fistula Parks modified virtual hanging line Rehabilitation process Transanal intersphincterotomy Wound healing

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	ZHANG Yan
	LIANG Lichuan
	HE Fang
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ZHANG Yan,LIANG Lichuan,HE Fang, et al. Curative Effect of Parks Modified Virtual Hanging Line Combined with TROPIS in the Treatment of High Intersphincter Anal Fistula[J]. HeBei Med, 2025, 31(1): 132-138.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.01.024 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I1/132

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