VM10 - Treatment of complex anal fistulas with suture-dragging therapy——3D Animation Demonstration

ONGOING VIDEOS

Location: ASCRS Connect Lounge, Hall B1/B2, Ground Level

Video Presentation(s)

Yang Liu (he/him/his)

Resident physician
Longhua Hospital Shanghai University of Traditional Chinese Medicine
Longhua Hospital Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

CW

Chen Wang, Consultant

Dean of Proctology Department
Longhua Hospital of Shanghai University of TCM
Shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

XT

Xiaochun Tao, Doctor of Medicine

Attending physician
Longhua Hospital Shanghai University of TCM
Shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.
HL

Hongtao Liang, Dr

Chief physician
Longhua hospital Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.
YY

Yibo Yao, n/a

Deputy Chief Physician
Longhua Hospital Shanghai University of Traditional Chinese Medicine
shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
QD

QIngjun Dong, n/a

Associate chief physician
Longhua hospital of Shanghai university of TCM
Shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Yang Liu: This individual has no financial relationships with ineligible companies.

Chen Wang, Consultant: This individual has no financial relationships with ineligible companies.

Yibo Yao, n/a: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Anal fistula is a benign disease that manifests with perianal or rectal symptoms. At present, surgery is the main method to treat anal fistula. Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract without disrupting the continence mechanism or injuring the sphincters. In 1980, Gu’s surgery team from Longhua Hospital Shanghai University of Traditional Chinese Medicine introduced suture-dragging therapy based on years of clinical experience, applied it to the treatment of anal fistula, and continuously expanded its application to horseshoe shaped perianal abscess, Crohn’s disease anal fistula, acute perianal necrotizing fasciitis, and sacrococcygeal pilonidal sinus. Suture-dragging therapy can effectively achieve the optimum goal of treating anal fistula.

Methods/Interventions: Suture-dragging therapy works by handing the internal opening of the fistula and eliminating necrotic tissue in the fistula. Place the patient in lithotomy position. A probe is used to figure out the main tract. Widen the external opening and internal opening, then remove inflammatory tissue and necrotic tissues. Ten sutures are put through the tract by the probe and knotted in loose ring. Treat the branches in the same way. Dressing change details are as follows: Wounds and fistulous track are irrigated with normal saline, and sprinkle medicine powder on the sutures. Turn the sutures to bring the powder into the fistula in order to remove the necrotic tissues. When the granulation tissue begins to grow, the sutures can be gradually removed. Once all sutures are removed, apply pressure to the wound with a cotton pad.

Results/Outcomes: The male patient in the case presentation in the video basically recovered one month after the surgery, with no postoperative complications and no recurrence at the fifth-year follow-up.

Conclusion/Discussion: Suture-dragging therapy can protect the normal skin and subcutaneous tissues above the tracks which is a safe, effective and less invasive treatment of complex anal fistula.