Effect of Modified Transsphincter Fistula Ligation on Anal Sphincter Function and Postoperative Pain in Patients with High-level Simple Anal Fistula

LU Hai; LAI Xiangquan

doi:10.13919/j.issn.2095-6274.ZHJY202501009

Abstract：Objective To investigate the impact of modified intersphincteric fistula ligation on anal sphinc-ter function and postoperative pain in patients with high anal simple fistulas.Methods A retrospective analy-sis was conducted on the clinical data of 70 patients diagnosed with high anal simple fistulas who were treated at Jinsha County Traditional Chinese Medicine Hospital from March 2022 to March 2024.Based on the surgical ap-proach,patients were divided into a study group(35 patients undergoing modified intersphincteric fistula ligation)and a control group(35 patients undergoing fistula excision and seton placement).The clinical efficacy,surgical-re-lated metrics,postoperative pain levels,anal sphincter function,and incidence of adverse reactions were compared between the two groups.Results The overall clinical effective rate in the study group was significantly higher than that in the control group(P＜0.05).Surgical duration,postoperative pain duration,length of hospital stay,and wound healing time were all significantly shorter in the study group compared to the control group(P＜0.05).Over time,the Visual Analog Scale(VAS)pain scores for both groups decreased significantly,with statistical significance(P＜0.05).Notably,VAS scores at 6 hours,12 hours,24 hours,and 48 hours postoperatively were significant-ly lower in the study group than in the control group(P＜0.001).Additionally,the resting anal canal pressure and initial sensory threshold levels in the study group were significantly higher than those in the control group(P＜0.001);the length of the anal canal high-pressure zone was significantly shorter in the study group.However,there were no significant differences between the two groups regarding rectal resting pressure and maximum anal contraction pressure(P＞0.05).The incidence of clinical complications was significantly lower in the study group compared to the control group(P＜0.05).Conclusion For patients with high anal simple fistulas,the modified intersphincteric fistula ligation technique better preserves anal sphincter function,effectively reduces postoperative pain,shortens wound healing time,and demonstrates a favorable safety profile.