अमूर्त

Comparison of curative effect of incision and drainage with cutting seton as well as incision and drainage on ischiorectal abscess and postanal space abscess

Jifu Yan, Genhai Li, Li'an Ma, Huanjun Xu

Objective: To compare the curative effect of incision and Drainage with Cutting Seton (IDCS) as well as Incision and Drainage (ID) on ischiorectal abscess and postanal space abscess.

Methods: A total of 81patients with ischiorectal abscess and postanal space abscess were divided as ID group and IDCS group according to different operation methods, in which there were 42 cases in ID group and 39 cases in IDCS group, the efficacy as well as the levels of serum inflammatory factors (Tumor necrosis factor-α, interleukin-6 and interleukin-8) and oxidative stress (superoxide dismutase and malondialdehyde) were compared between the two groups before and after treatment.

Results: There was no statistically significant difference between IDCS group and ID group in operation time, anorectal pain score at 6 h after operation, the incidence of postoperative urinary retention, postoperative bleeding and postoperative hospitalization days (P>0.05); the incidence rate of anal fistula in IDCS group at 3 months after operation was10.3% (4/39 cases), significantly lower than that in ID group, that was 90.5% (38/42) (P<0.05); before operation, there was no significant difference between the two groups in the levels of serum Tumor Necrosis Factor-α (TNF-a), Interleukin-6 (IL -6) and Interleukin-8 (IL -8) (P>0.05), while 3 w after operation, the levels of serum TNF-a, IL -6 and IL -8 in IDCS group were significantly lower than those in ID group (P<0.05); before operation, there was no significant difference between the two groups in the levels of oxidative stress indexes of serum Superoxide Dismutase (SOD) and Malondialdehyde (MDA) (P>0.05), while at 3 w after operation, the level of SOD was significantly higher (P<0.05) and MDA level significantly lower (P<0.05) in IDCS group than in ID group.

Conclusion: IDCS is a safe and feasible choice for the treatment of ischiorectal abscess and postanal space abscess with fewer rates of anal fistula and reoperation as well as reduced inflammatory factor level and oxidative stress injury.