Objective To summarize the research progression of video-assisted anal fistula treatment (VAAFT). Methods The related literatures in recent years were reviewed, and then the operation principle, operation process, advantages and disadvantages, matters needing attention, and clinical application of VAAFT were summarized. Results VAAFT is the treatment of fistulas by endoscopy. It don’t require the incision or resection of the fistula. It has the advantages of less surgical trauma, faster postoperative recovery, and less impact on the anal sphincter. The disadvantage of this method is relatively strict indications, fistula bending or horseshoe fistula is not suitable for this method. In addition, the endoscope using during the operation is a rigid mirror tube, and the operation is not convenient enough, so technical improvement is needed in the future. We should pay attention to distinguish true fistula and false fistula in clinical practice; the wall of the fistula should be adequately burned and the necrotic tissue should be cleaned; the treatment of the internal opening of anal fistula must be exact; the time of the first defecation should be appropriately delayed, and the incidence of infection should be reduced after operation. At present, the clinical reports of VAAFT are increasing gradually in foreign countries, and these reports have achieved good therapeutic effect. It is considered that this method maybe a safe and effective minimally invasive surgical treatment for anal fistula. However, there is few clinical reports on VAAFT in China, and it is still in the preliminary stage of exploration. Conclusion VAAFT is a new technology in the treatment of anal fistula, and it has advantages of minimally invasive, sphincter preservation, and so on, which is worthy of clinical application.
ObjectiveTo observe the effect of modified ligation of intersphincteric fistula tract (LIFT) combined with acellular anal fistula repair matrix packing in the treatment of high anal fistula, and to evaluate its clinical efficacy and safety.MethodsAll 86 patients who met the diagnostic criteria of high anal fistula in Beijing Anorectal Hospital from October 2018 to August 2019 were selected and randomly divided into observation group and control group. The observation group was treated with modified LIFT combined with acellular anal fistula repair matrix tamponade, while the control group was treated with traditional low incision and high thread drawing surgery. The curative effect, wound healing time, postoperative pain score, intraoperative blood loss, postoperative complications, hospitalization time, patient satisfaction and recurrence at 6 months after operation were compared between the two groups.ResultsThe effective rate of the observation group was 92.9% (39/42), and that of the control group was 86.4% (38/44), there was no significant difference between the two groups (Z=−1.251, P=0.211). The healing time of the observation group and the control group were (24.8±8.5) days and (32.1±10.9) days, respectively, the difference was statistically significant (t=3.472, P<0.001). Compared with the control group, the observation group had less intraoperative blood loss, less postoperative pain and shorter hospital stay (P<0.05). There was no anal incontinence after operation in the two groups, and the incidence of postoperative complications such as bloody stool, anal border edema and urinary retention were lower in the observation group (11.9%) compared with the control group (31.8%), with a statistically significant difference (P<0.05). The treatment satisfaction of the observation group was 90.5%, and that of the control group was 81.8%. There was no significant difference between the two groups (Z=−1.284, P>0.05).ConclusionModified LIFT combined with acellular anal fistula repair matrix in the treatment of high anal fistula has the advantages of small trauma, quick recovery and low incidence of complications.
Objective To evaluate the value of methylated Septin9 (mSEPT9) in the diagnosis and postoperative recurrence/metastasis monitoring of colorectal cancer. Methods A total of 76 patients with colorectal cancer who were hospitalized in Beijing Anorectal Hospital (Beijing Erlonglu Hospital) and positive for mSEPT9 before operation from January to December in 2020 were collected. Nineteen patients who were still positive for mSEPT9 at one week after operation were selected as the msept9 positive group, and 57 patients whose mSEPT9 became negative were selected as the msept9 negative group. The clinicopathological features and postoperative recurrence and metastasis of the two groups were analyzed and compared. Results There were significant differences in lymph node metastasis rate, vascular or nerve infiltration and clinical staging between the mSEPT9 positive group and the mSEPT9 negative group (P=0.024, P=0.009, P=0.009). There was no significant difference in age, gender, tumor location, degree of tumor differentiation, and tumor invasion depth (T stage), P>0.05. Two patients in the mSEPT9 positive group had liver metastases after operation, and there were no cases of metastasis or recurrence in the mSEPT9 negative group (P=0.024). Conclusion The mSEPT9 can be used as a potential tumor marker for the diagnosis of colorectal cancer and the monitoring of postoperative treatment effect, and more attention should be paid to patients who are still positive for mSEPT9 after surgery.