Effect of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal opening of anal fistula

WENG Heyu; CHEN Qi; XIA Wenhao; ZHANG Weiwei; HUANG Ping

doi:10.7619/jcmp.20223793

Journal of Clinical Medicine in Practice > 2023 > 27(9): 123-126. > DOI: 10.7619/jcmp.20223793

WENG Heyu, CHEN Qi, XIA Wenhao, ZHANG Weiwei, HUANG Ping. Effect of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal opening of anal fistula[J]. Journal of Clinical Medicine in Practice, 2023, 27(9): 123-126. DOI: 10.7619/jcmp.20223793

Citation:

PDF (594 KB)

Effect of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal opening of anal fistula

Department of Colorectal Surgery, Sir Run Run Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 211112

More Information

Received Date: December 19, 2022
Revised Date: March 16, 2023
Available Online: May 24, 2023

Graphical Abstract

Abstract

Abstract

Objective
To investigate the accuracy of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal orifice and its surgical efficacy for anal fistula.
Methods
A total of 86 patients with anal fistula admitted to Sir Run Run Hospital Affiliated to Nanjing Medical University were selected as study objects, and were randomly divided into observation group (43 cases) and control group(43 cases). All patients underwent pelvic 3.0T pelvic magnetic resonance imaging examination before operation. The fistula distribution was assessed. In the observation group, hydrogen peroxide solution was slowly injected through the external opening to locate the internal opening of anal fistula. The control group used traditional anal fistula probe combined with digital rectal examination to locate the internal opening of anal fistula. The accuracy of intraoperative positioning of the internal orifice of anal fistula in the two groups and the accuracy of the internal orifice positioning in complex anal fistula cases were compared. Visual Analog Scale (VAS) was used to evaluate the wound pain of patients 1 week after surgery, and the number of postoperative recurrent anal fistulas, postoperative wound healing time and the incidence of wound complications were compared between the two groups.
Results
The positioning accuracy rate of the anal internal opening in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05). The number of complex anal fistula in patients in the observation group was more than that in the control group(10 cases versus 4 cases, P < 0.05). One week after surgery, VAS score of observation group was (1.53±0.91), which was lower than (2.28±0.98) in the control group, and the difference was statistically significant(P < 0.05). The wound healing time in the observation group was shorter than that in the control group [(25.37±3.86) d versus (29.05±2.62) d, P < 0.05].
Conclusion
Preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution is accurate in locating the internal orifice of anal fistula, can relieve the pain of patients′ wounds, and reduce the incidence of postoperative complications, therefore, it is beneficial to wound healing.
- anal fistula,
- pelvic magnetic resonance imaging,
- hydrogen peroxide solution,
- internal orifice of anal fistula,
- wound pain,
- complications,
- wound healing

FullText(HTML)

References (17)

References

[1]	CIROCCHI R, TRASTULLI S, MORELLI U, et al. The treatment of anal fistulas with biologically derived products: is innovation better than conventional surgical treatment An update[J]. Tech Coloproctol, 2013, 17(3): 259-273. doi: 10.1007/s10151-012-0948-9
[2]	CHUNG W, KO D, SUN C, et al. Outcomes of anal fistula surgery in patients with inflammatory bowel disease[J]. Am J Surg, 2010, 199(5): 609-613. doi: 10.1016/j.amjsurg.2010.01.007
[3]	RIZZO J A, NAIG A L, JOHNSON E K. Anorectal abscess and fistula-in-ano: evidence-based management[J]. Surg Clin North Am, 2010, 90(1): 45-68. doi: 10.1016/j.suc.2009.10.001
[4]	BEETS-TAN R G, BEETS G L, VAN DER HOOP A G, et al. Preoperative MR imaging of anal fistulas: does it really help the surgeon[J]. Radiology, 2001, 218(1): 75-84. doi: 10.1148/radiology.218.1.r01dc0575
[5]	金佳熙, 李晓卿, 刘耀, 等. 3D CUBE T₂WI抑脂序列联合常规序列对肛瘘的诊断价值[J]. 中国中西医结合影像学杂志, 2019, 17(2): 191-193. doi: 10.3969/j.issn.1672-0512.2019.02.024
[6]	NAGENDRANATH C, SARAVANAN M N, SRIDHAR C, et al. Peroxide-enhanced endoanal ultrasound in preoperative assessment of complex fistula-in-ano[J]. Tech Coloproctol, 2014, 18(5): 433-438. doi: 10.1007/s10151-013-1067-y
[7]	中国医师协会肛肠医师分会临床指南工作委员会. 肛瘘诊治中国专家共识(2020版)[J]. 中华胃肠外科杂志, 2020, 23(12): 1123-1130. doi: 10.3760/cma.j.cn.441530-20200925-00537
[8]	ROJANASAKUL A, PATTANAARUN J, SAHAKITRUNGRUANG C, et al. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract[J]. Chotmaihet Thangphaet, 2007, 90(3): 581-586.
[9]	CIROCCO W C, REILLY J C. Challenging the predictive accuracy of Goodsall's rule for anal fistulas[J]. Dis Colon Rectum, 1992, 35(6): 537-542. doi: 10.1007/BF02050532
[10]	KIM Y, PARK Y J. Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂ enhancement[J]. World J Gastroenterol, 2009, 15(38): 4810. doi: 10.3748/wjg.15.4810
[11]	CHOEN S, BURNETT S, BARTRAM C I, et al. Comparison between anal endosonography and digital examination in the evaluation of anal fistulae[J]. Br J Surg, 1991, 78(4): 445-447.
[12]	KHATI N J, SONDEL LEWIS N, FRAZIER A A, et al. CT of acute perianal abscesses and infected fistulae: a pictorial essay[J]. Emerg Radiol, 2015, 22(3): 329-335. doi: 10.1007/s10140-014-1284-3
[13]	BALC X S, ONUR M R, KARAOSMANO X F, et al. MRI evaluation of anal and perianal diseases[J]. Diagn Interv Radiol, 2019, 25(1): 21-27. doi: 10.5152/dir.2018.17499
[14]	SAHNI V A, AHMAD R, BURLING D. Which method is best for imaging of perianal fistula[J]. Abdom Imaging, 2008, 33(1): 26-30. doi: 10.1007/s00261-007-9309-y
[15]	TOZER P J, BURLING D, GUPTA A, et al. Review article: medical, surgical and radiological management of perianal Crohn's fistulas[J]. Aliment Pharmacol Ther, 2011, 33(1): 5-22. doi: 10.1111/j.1365-2036.2010.04486.x
[16]	王宇. 3.0 T磁共振多序列成像在肛瘘诊断分型中的应用效果分析[J]. 中国实用医药, 2022, 17(1): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202201001.htm
[17]	URIBE N, BALCISCUETA Z, MÍNGUEZ M, et al. "Core out" or "curettage" in rectal advancement flap for cryptoglandular anal fistula[J]. Int J Colorectal Dis, 2015, 30(5): 613-619. doi: 10.1007/s00384-015-2133-x

[1]	ZOU Yingcai, ZHOU Li, WANG Jiangning, GAO Lei. Effects of antibiotic-loaded bone cement coverage versus negative pressure wound therapy on diabetic foot ulcer wound healing[J]. Journal of Clinical Medicine in Practice, 2024, 28(23): 105-109, 115. DOI: 10.7619/jcmp.20243314
[2]	WANG Haihong, XU Yinan, JIAO Hao. Role of chlorophyll derivative in improving wound healing after hemorrhoidectomy[J]. Journal of Clinical Medicine in Practice, 2024, 28(1): 90-93. DOI: 10.7619/jcmp.20232914
[3]	YANG Yuan, YU Chenghao, ZUO Rui, LIU Zhe, FU Yi, HOU Ruixing. Research progress on role and mechanism of angiopoietin-like protein 4 in skin wound healing[J]. Journal of Clinical Medicine in Practice, 2022, 26(23): 134-137, 142. DOI: 10.7619/jcmp.20222677
[4]	XIE Zhennian, AN Xiaojing, ZHOU Haiyang, WANG Fangli, WANG Liping. Effect of compound chamomile and lidocaine hydrochloride gel on skin wound healing in rats[J]. Journal of Clinical Medicine in Practice, 2022, 26(17): 18-23. DOI: 10.7619/jcmp.20222308
[5]	XIONG Shi, SUN Changsheng, LIN Cuiling. Effect of skin soft tissue expansion and composite skin transplantation on recovery time of wound healing and skin blood supply in burn patients[J]. Journal of Clinical Medicine in Practice, 2020, 24(13): 26-28. DOI: 10.7619/jcmp.202013008
[6]	LI Yanhui, ZHANG Li, XIAO Houan. Therapeutic effect of local oxygen therapy on woundhealing in patients with chronic wound skin graft[J]. Journal of Clinical Medicine in Practice, 2019, 23(13): 27-29. DOI: 10.7619/jcmp.201913007
[7]	CAO Fangmin, WANG Chunmei, LI Shan. Effect of different cold compress methods on postoperative pain and wound healing after tonsillectomy[J]. Journal of Clinical Medicine in Practice, 2019, 23(9): 81-84. DOI: 10.7619/jcmp.201909023
[8]	WANG Chunmei, CAO Fangmin, XU Min, CHENG Fang. Effect of evidence-based pain nursing on postoperative pain and wound healing in patients with hemorrhoid surgery[J]. Journal of Clinical Medicine in Practice, 2019, 23(8): 104-107. DOI: 10.7619/jcmp.201908029
[9]	HU Liang, SUN Bingwei, XIAO Guixi, YU Ye. Effect of bioactive glass combined with bath therapy on treatment of patients with residual burn wound[J]. Journal of Clinical Medicine in Practice, 2014, (9): 72-75. DOI: 10.7619/jcmp.201409020
[10]	LIU Min, ZHANG Bing, ZHANG Liping. Influence of comprehensive nursing intervention on healing of wound in patients with anterior cervical operation[J]. Journal of Clinical Medicine in Practice, 2013, (12): 74-76. DOI: 10.7619/jcmp.201312028

Cited By

Cited by

Periodical cited type(6)

1.	沈良伟，李涛，金祝华，黄刚. CT定位辅助神经内镜手术对脑包虫病的疗效分析. 临床神经病学杂志. 2023(01): 39-43 .
2.	廖佳奇，许金仙，叶新运，温小华. 桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响. 广州医药. 2023(05): 61-64+69 .
3.	宋少谦. 神经内镜辅助显微手术治疗囊性脑肿瘤的疗效观察. 临床研究. 2022(11): 8-11 .
4.	蔡昌呈，陈星宇，向城卫，刘应刚，李维民，罗可. 神经内镜联合颅底显微神经外科手术对脑肿瘤患者的影响. 内蒙古医科大学学报. 2022(06): 634-636+640 .
5.	侯晓峰，张春阳. 探讨神经内镜辅助显微手术应用于囊性脑肿瘤患者治疗的临床效果. 影像研究与医学应用. 2020(13): 219-220 .
6.	杨文凯. 神经内镜辅助显微手术治疗囊性脑肿瘤的疗效观察. 航空航天医学杂志. 2020(11): 1342-1343 .

Other cited types(0)

Get Citation

PDF

XML

Article views (143) PDF downloads (9) Cited by(6)

Turn off MathJax

Article Contents

Abstract

References

Effect of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal opening of anal fistula

Abstract

References

Related Articles

Cited by

Periodical cited type(6)

Other cited types(0)

Catalog

Effect of preoperative pelvic magnetic resonance imaging combined with intraoperative injection of hydrogen peroxide solution to locate the internal opening of anal fistula

Abstract

References

Related Articles

Cited by

Periodical cited type(6)

Other cited types(0)

Catalog

Export File

Citation

Format

Content