經括約肌間瘺管結扎術治療肛瘺的臨床現狀_《華西醫學》

作者：

張少軍 ^1,2 ,  楊巍 ¹

1上海中醫藥大學附屬曙光醫院肛腸科（上海，201203）;2上海市嘉定區中醫醫院肛腸科;

關鍵詞：

直腸瘺經括約肌間瘺管結扎術治療結果手術后并發癥

DOI：

10.7507/1002-0179.20130097

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經括約肌間瘺管結扎（LIFT）術是近年來治療肛瘺的新術式，具有傷口小、肛門功能損傷小的優點，越來越受到國內外學者的關注。目前LIFT術的臨床療效差異較大，手術適應證較寬泛，手術失敗原因不明，有必要對LIFT術的理論依據、操作方法、優缺點、注意事項及臨床應用等情況作全面的了解。現對LIFT術的臨床現狀及爭議等情況作一綜述。

引用本文： 張少軍,楊巍. 經括約肌間瘺管結扎術治療肛瘺的臨床現狀. 華西醫學, 2013, 28(2): 302-305. doi: 10.7507/1002-0179.20130097 復制

1.	Whiteford MH, Kilkenny J, Hyman N, et al. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised)[J]. Dis Colon Rectum, 2005, 48(7): 1337-1342.
2.	Han KS, Cho HM, Kim DH, et al. Retrospective analysis of a fistula-in-ano: focus on an anal-sphincter-preserving procedure[J]. J Korean Soc Coloproctol, 2007, 23(6): 403-409.
3.	Lim SW. Surgery in an intersphincteric fistula[J]. J Korean Soc Coloproctol, 2009, 25(6): 365-371.
4.	Kronborg O. To lay open or excise a fistula-in-ano: a randomized trial[J]. Br J Surg, 1985, 72(12): 970.
5.	Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano: the ligation of intersphincteric fistula tract[J]. J Med Assoc Thai, 2007, 90(3): 581-586.
6.	Parks AG. Pathogenesis and treatment of fistula-in-ano[J]. Br Med J, 1961, 1(5224): 463-469.
7.	Rojanasakul A. LIFT procedure: a simplified technique for fistula-in-ano[J]. Tech Coloproctol, 2009, 13(3): 237-240.
8.	Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano[J]. Dis Colon Rectum, 2010, 53(1): 39-42.
9.	Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas[J]. Dis Colon Rectum, 2010, 53(1): 43-46.
10.	Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano[J]. Dis Colon Rectum, 2011, 54(3): 289-292.
11.	Tan K, Tan I, Koh DC, et al. Long-term results of ligation of intersphincteric fistula tract (LIFT) technique in the management of anal fistula[C]// American Society of Colon and Rectal Surgeons. 2010 ASCRS Annual Meeting. 2010 15-19, Minneapolis, MN, USA, Arlington Heights, IL: 2010: 155.
12.	Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study[J]. Tech Coloproctol, 2011, 15(4): 413-416.
13.	Tan KK, Tan IJ, Lim FS, et al. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years[J]. Dis Colon Rectum, 2011, 54(11): 1368-1372.
14.	Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience[J]. Colorectal Dis, 2012, 14(5): 599-603.
15.	Abcarian AM, Estrada JJ, Park J, et al. Ligation of intersphincteric fistula tract: early results of a pilot study[J]. Dis Colon Rectum, 2012, 55(7): 778-782.
16.	Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage[J]. Am J Surg, 2012, 204(3): 283-289.
17.	van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistula: a new technique to avoid fistulotomy [J]. Colorectal Dis, 2012. [Epub ahead of print].
18.	García-Aguilar J, Belmonte C, Wong DW, et al. Cutting seton versus two-stage seton fistulotomy in the surgical management of high anal fistula[J]. Br J Surg, 1998, 85(2): 243-245.
19.	Williams JG, MacLeod CA, Rothenberger DA, et al. Seton treatment of high anal fistulae[J]. Br J Surg, 1991, 78(10):1159-1161.
20.	Pearl RK, Andrews JR, Orsay CP, et al. Role of the seton in the management of anorectal fistulas[J]. Dis Colon Rectum, 1993, 36(6): 573-577.
21.	Hamalainen KP, Sainio AP. Cutting seton for anal fistulas: high risk of minor control defects[J]. Dis Colon Rectum, 1997, 40(12): 1443-1446.
22.	Mizrahi N, Wexner SD, Zmora O, et al. Endorectal advancement flap: are there predictors of failure? [J]. Dis Colon Rectum, 2002, 45(12): 1616-1621.
23.	Gustafsson UM, Graf W. Excision of anal fistula with closure of the internal opening: functional and manometric results[J]. Dis Colon Rectum, 2002, 45(12): 1672-1678.
24.	Kreis ME, Jehle EC, Ohlemann M, et al. Functional results after transanal rectal advancement flap repair of trans-sphincteric fistula[J]. Br J Surg, 1998, 85(2): 240-242.
25.	Song KH. New techniques for treating an anal fistula[J]. J Korean Soc Coloproctol, 2012, 28(1): 7-12.
26.	Bleier JI, Moloo H. Current management of cryptoglandular fistula-in-ano[J]. World J Gastroenterol, 2011, 17(28): 3286-3291.
27.	Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas[J]. Dis Colon Rectum, 2006, 49(3): 371-376.
28.	Champagne BJ, O’Connor LM, Ferguson M, et al. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up[J]. Dis Colon Rectum, 2006, 49(12): 1817-1821.
29.	Lawes DA, Efron JE, Abbas M, et al. Early experience with the bioabsorbable anal fistula plug[J]. World J Surg, 2008, 32(6): 1157-1159.
30.	Safar B, Jobanputra S, Sands D, et al. Anal fistula plug: initial experience and outcomes[J]. Dis Colon Rectum, 2009, 52(2): 248-252.
31.	Matos D, Lunniss PJ, Phillips RKS. Total sphincter conservation in high fistula in ano: results of a new approach[J]. Br J Surg, 1993, 80(6): 802-804.
32.	Rojanasakul A. Comments to the invited comment "LIFT procedure: a simplified technique for fistula in ano" by P. J. Lunniss[J]. Tech Coloproctol, 2010, 14(1): 53-54.
33.	van Onkelen RS, Gosselink MP, Schouten WR. Is it possible to improve the outcome of transanal advancement flap repair for high transsphincteric fistulas by additional ligation of the intersphincteric fistula tract? [J]. Dis Colon Rectum, 2012, 55(2): 163-166.
34.	王振軍. 肛瘺治療新手術：LIFT-Plug術[J]. 中國臨床醫生, 2011, 39(8): 8-9.
35.	崔金杰, 王振軍, 鄭毅, 等. 改良括約肌間瘺管結扎術治療經括約肌型肛瘺[J]. 中華胃腸外科雜志, 2012, 15(12): 1232-1235.
36.	Han JG, Yi BQ, Wang ZJ, et al. Ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano[J]. Colorectal Dis, 2012. [Epub ahead of print].

1. 　Whiteford MH, Kilkenny J, Hyman N, et al. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised)[J]. Dis Colon Rectum, 2005, 48(7): 1337-1342.
2. 　Han KS, Cho HM, Kim DH, et al. Retrospective analysis of a fistula-in-ano: focus on an anal-sphincter-preserving procedure[J]. J Korean Soc Coloproctol, 2007, 23(6): 403-409.
3. 　Lim SW. Surgery in an intersphincteric fistula[J]. J Korean Soc Coloproctol, 2009, 25(6): 365-371.
4. 　Kronborg O. To lay open or excise a fistula-in-ano: a randomized trial[J]. Br J Surg, 1985, 72(12): 970.
5. 　Rojanasakul A, Pattanaarun J, Sahakitrungruang C, et al. Total anal sphincter saving technique for fistula-in-ano: the ligation of intersphincteric fistula tract[J]. J Med Assoc Thai, 2007, 90(3): 581-586.
6. 　Parks AG. Pathogenesis and treatment of fistula-in-ano[J]. Br Med J, 1961, 1(5224): 463-469.
7. 　Rojanasakul A. LIFT procedure: a simplified technique for fistula-in-ano[J]. Tech Coloproctol, 2009, 13(3): 237-240.
8. 　Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano[J]. Dis Colon Rectum, 2010, 53(1): 39-42.
9. 　Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas[J]. Dis Colon Rectum, 2010, 53(1): 43-46.
10. 　Aboulian A, Kaji AH, Kumar RR. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano[J]. Dis Colon Rectum, 2011, 54(3): 289-292.
11. 　Tan K, Tan I, Koh DC, et al. Long-term results of ligation of intersphincteric fistula tract (LIFT) technique in the management of anal fistula[C]// American Society of Colon and Rectal Surgeons. 2010 ASCRS Annual Meeting. 2010 15-19, Minneapolis, MN, USA, Arlington Heights, IL: 2010: 155.
12. 　Sileri P, Franceschilli L, Angelucci GP, et al. Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study[J]. Tech Coloproctol, 2011, 15(4): 413-416.
13. 　Tan KK, Tan IJ, Lim FS, et al. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years[J]. Dis Colon Rectum, 2011, 54(11): 1368-1372.
14. 　Ooi K, Skinner I, Croxford M, et al. Managing fistula-in-ano with ligation of the intersphincteric fistula tract procedure: the Western Hospital experience[J]. Colorectal Dis, 2012, 14(5): 599-603.
15. 　Abcarian AM, Estrada JJ, Park J, et al. Ligation of intersphincteric fistula tract: early results of a pilot study[J]. Dis Colon Rectum, 2012, 55(7): 778-782.
16. 　Mushaya C, Bartlett L, Schulze B, et al. Ligation of intersphincteric fistula tract compared with advancement flap for complex anorectal fistulas requiring initial seton drainage[J]. Am J Surg, 2012, 204(3): 283-289.
17. 　van Onkelen RS, Gosselink MP, Schouten WR. Ligation of the intersphincteric fistula tract in low transsphincteric fistula: a new technique to avoid fistulotomy [J]. Colorectal Dis, 2012. [Epub ahead of print].
18. 　García-Aguilar J, Belmonte C, Wong DW, et al. Cutting seton versus two-stage seton fistulotomy in the surgical management of high anal fistula[J]. Br J Surg, 1998, 85(2): 243-245.
19. 　Williams JG, MacLeod CA, Rothenberger DA, et al. Seton treatment of high anal fistulae[J]. Br J Surg, 1991, 78(10):1159-1161.
20. 　Pearl RK, Andrews JR, Orsay CP, et al. Role of the seton in the management of anorectal fistulas[J]. Dis Colon Rectum, 1993, 36(6): 573-577.
21. 　Hamalainen KP, Sainio AP. Cutting seton for anal fistulas: high risk of minor control defects[J]. Dis Colon Rectum, 1997, 40(12): 1443-1446.
22. 　Mizrahi N, Wexner SD, Zmora O, et al. Endorectal advancement flap: are there predictors of failure? [J]. Dis Colon Rectum, 2002, 45(12): 1616-1621.
23. 　Gustafsson UM, Graf W. Excision of anal fistula with closure of the internal opening: functional and manometric results[J]. Dis Colon Rectum, 2002, 45(12): 1672-1678.
24. 　Kreis ME, Jehle EC, Ohlemann M, et al. Functional results after transanal rectal advancement flap repair of trans-sphincteric fistula[J]. Br J Surg, 1998, 85(2): 240-242.
25. 　Song KH. New techniques for treating an anal fistula[J]. J Korean Soc Coloproctol, 2012, 28(1): 7-12.
26. 　Bleier JI, Moloo H. Current management of cryptoglandular fistula-in-ano[J]. World J Gastroenterol, 2011, 17(28): 3286-3291.
27. 　Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas[J]. Dis Colon Rectum, 2006, 49(3): 371-376.
28. 　Champagne BJ, O’Connor LM, Ferguson M, et al. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up[J]. Dis Colon Rectum, 2006, 49(12): 1817-1821.
29. 　Lawes DA, Efron JE, Abbas M, et al. Early experience with the bioabsorbable anal fistula plug[J]. World J Surg, 2008, 32(6): 1157-1159.
30. 　Safar B, Jobanputra S, Sands D, et al. Anal fistula plug: initial experience and outcomes[J]. Dis Colon Rectum, 2009, 52(2): 248-252.
31. 　Matos D, Lunniss PJ, Phillips RKS. Total sphincter conservation in high fistula in ano: results of a new approach[J]. Br J Surg, 1993, 80(6): 802-804.
32. 　Rojanasakul A. Comments to the invited comment "LIFT procedure: a simplified technique for fistula in ano" by P. J. Lunniss[J]. Tech Coloproctol, 2010, 14(1): 53-54.
33. 　van Onkelen RS, Gosselink MP, Schouten WR. Is it possible to improve the outcome of transanal advancement flap repair for high transsphincteric fistulas by additional ligation of the intersphincteric fistula tract? [J]. Dis Colon Rectum, 2012, 55(2): 163-166.
34. 　王振軍. 肛瘺治療新手術：LIFT-Plug術[J]. 中國臨床醫生, 2011, 39(8): 8-9.
35. 　崔金杰, 王振軍, 鄭毅, 等. 改良括約肌間瘺管結扎術治療經括約肌型肛瘺[J]. 中華胃腸外科雜志, 2012, 15(12): 1232-1235.
36. 　Han JG, Yi BQ, Wang ZJ, et al. Ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug (LIFT-Plug): a new technique for fistula-in-ano[J]. Colorectal Dis, 2012. [Epub ahead of print].

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《華西醫學》

經括約肌間瘺管結扎術治療肛瘺的臨床現狀

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《華西醫學》

經括約肌間瘺管結扎術治療肛瘺的臨床現狀

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