A PRIMARY LESION OPENING SURGERY FOR ANAL FISTULA-LOCALIZED LAYING OPEN PROCEDURE-

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  • 痔ろうに対する原発巣開放手術―限局的ｌａｙｉｎｇ　ｏｐｅｎ法―

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The purpose of this study was to establish a primary lesion opening surgery for anal fistula, an operative procedure which can be indicated for almost all anal fistulae and is a simple procedure causing minimal impairment to the postoperative anal function.<br>A total of 27 patients with (high) anal fistula treated at the hospital from August 1999 to December 2001 were enrolled in this study. These patients underwent an operative procedure in which the internal opening, primary fistula, and primary lesion were removed together with subcutaneous external sphincter muscle of anus to create an open wound with good drainage, and the secondary fistula and the secondary opening were left intact.<br>Observation time ranged from 12 to 40 months, with the mean of 29 months. No recurrence has occurred. The mean hospital stay was 13 days. Durations until cure of the surgical wound after the operation ranged from 7 to 17 weeks, with the mean of 10 weeks. All remnant secondary fistulae and openings became scars. A questionnaire survey was conducted in 26 out of the 27 patients. Four (15%) patients complained of frequent passing of gas, but no patients answered to have incontinence of feces. We could obtain overall favorable outcomes as 19 patients (73%) answered to have almost no problems.<br>In conclusion, this study has clarified that this primary lesion opening procedure (localized laying open procedure) that we have developed can be used in place of the conventional laying open procedure for anal fistula hereafter.

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