Anterior ilioinguinal incision for drainage of high-located perianal abscess

Study on the factors influencing the prognosis after perianal abscess surgery

OBJECTIVE

To study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to provide a basis for selecting appropriate surgical and inspection methods for clinical treatment of perianal abscess in the future.

METHODS

The clinical data of 394 patients with perianal abscesses were collected, the influencing factors were investigated, and univariate analysis and multivariate logistic regression analysis were performed to further determine the risk factors affecting the prognosis of perianal abscess.

RESULTS

The results showed that the rate of preoperative blood routine results in the uncured group was higher (51.16%) than in the cured group (35.61%); the rate of high abscess space in the uncured group (23.26%) was higher than in the cured group (9.11%); the proportion of patients in the uncured group who underwent magnetic resonance imaging (MRI) before surgery (27.90%) was lower than in the cured group (45.30%); the proportion of patients in the uncured group who underwent simple drainage (51.16%) was higher than in the cured group (28.49%). The two groups had significant differences in perineal MRI examination, surgical method, preoperative blood routine, and abscess space (p = 0.030, p = 0.002, p = 0.047 and p = 0.010, respectively). Based on the results of univariate analysis and multivariate logistic regression analysis, the extent of the abscess cavity (OR = 2.544, 95%CI = 1.087-5.954, p = 0.031) and the surgical method (OR = 2.180, 95%CI = 1.091-4.357, p = 0.027) were independent influencing factors for postoperative recurrence of perianal abscess or anal fistula.

CONCLUSION

Preoperative assessment of the abscess range and precise intraoperative methods to resolve the infection of the abscess glands in the internal mouth can effectively improve the cure rate.

A prospective cohort study of safety and efficacy of three-cavity clearance in treatment of perianal cryptoglandular abscess

BACKGROUND

Perianal abscess is a common anorectal disease, mainly caused by anal gland infection. Abscess, once formed, should be timely treated. At present, there are many methods available to treat perianal abscess, but each of them has some shortcomings. According to the physiological and pathological mechanism of perianal abscess, we designed a new surgical method named three-cavity clearance (TCC) to maximize the protection of anal sphincter function and reduce the pain of patients.

AIM

To evaluate the safety and efficacy of TCC in perianal cryptoglandular abscess.

Methods

From January 2017 to January 2018, perianal abscess patients who underwent TCC at the Center for Anorectal Diagnosis and Treatment of the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were selected as a study group. Patients who underwent simple incision and drainage for perianal abscess during the same period were selected into a control group. The two groups were 1:1 paired with comparable age, sex, and abscess site. Hospitalization time, wound healing time, anal fistula formation rate, and anal incontinence were compared between the two groups.

RESULTS

There were 32 patients in each group and a total of 64 patients were included in this study. The formation rate of anal fistula in the TCC group was 6%, significantly lower than that in the control group (34.0%, P < 0.01). There was no anal incontinence in either group. The hospitalization time and wound healing time of the two groups showed no statistical difference (P > 0.05).

CONCLUSION

TCC for perianal abscess is a safe and complete anal sphincter preserving technique, which can effectively reduce the rate of postoperative anal fistula formation.