Loose combined cutting seton for patients with high intersphincteric fistula: a retrospective study

Zheng, Lihua; Shi, Yuying; Zhi, Congcong; Yu, Qiuxiang; Li, Xin; Wu, Shanshan; Zhang, Wen; Liu, Yanjun; Huang, Zichen

doi:10.21037/atm-20-6123

Cited by 14 publications

(19 citation statements)

References 24 publications

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“…In this study, 217 pSS participants were followed up for 1-18 years, with a median follow-up of 8 [4][5][6][7][8][9][10][11][12] years. The ILD group was followed up for 8 [5][6][7][8][9][10][11] years, the NILD group was followed up for 8 [4][5][6][7][8][9][10][11][12] rechecked by HRCT. In total, 89 cases (41.0%) with ILD were identified in this study.…”

Section: Follow-up Outcomementioning

confidence: 99%

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The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Zhang¹,

Li²,

Cai³

et al. 2021

Ann Palliat Med

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Background: During the course of disease, some patients with primary Sjögren's syndrome (pSS) develop interstitial lung disease (ILD), which leads to a poor prognosis. There is currently a lack of methods to identify high-risk patients with ILD and predict the prognosis. The purpose of this study was to analyze the predictive value of the neutrophil to lymphocyte ratio (NLR) for the occurrence of ILD and its prognosis in patients with pSS.Methods: According to the inclusion and exclusion criteria, patients with pSS admitted to our hospital from May 2009 to November 2020 were included. The patients were divided into either an ILD group or a non-interstitial pneumonia [non-ILD (NILD)] group. We compared the baseline data of the two groups of participants, and the participants were followed up (≥1 year) at clinic visits. Logistic multivariate regression analysis was used to analyze the risk factors related to ILD and prognosis in patients with pSS.Results: A total of 217 patients with pSS were included, of which 71 (32.7%) participants were diagnosed with ILD (ILD group) at the time of pSS diagnosis, and 146 (67.3%) participants had no obvious ILD (NILD group). Based on follow-up results, logistic multivariate analysis revealed that NLR [relative risk (RR) =1.81,

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Section: Follow-up Outcomementioning

confidence: 99%

“…The quality of life (QOL) is significantly reduced, and the 5-year mortality rate can increase by 16%. The 10-year overall mortality rate of pSS patients with ILD is 4 times of those patients without ILD (4)(5)(6). Therefore, it is particularly important to identify high-risk pSS patients with ILD as early as possible.…”

Section: Introductionmentioning

confidence: 99%

The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Zhang¹,

Li²,

Cai³

et al. 2021

Ann Palliat Med

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“…LCCS can reduce the pain experienced by patients and the manpower required by doctors to repeatedly tighten the thread to the greatest extent. This method has been preliminarily proven to have a high healing rate and good safety (25). The purpose of this single-center randomized controlled trial is to further verify the efficacy and safety of the LCCS method, in order to promote its clinical applications.…”

Section: Confidentiality Measuresmentioning

confidence: 99%

“…The virtual thread will be kept for about 21 days to ensure the healing process is successful. This therapy has been shown to have a definite curative effect (25). A single-center randomized controlled trial will be conducted to observe and compare the clinical efficacy and the incidence of postoperative complications of LCCS and traditional CS therapy.…”

Section: Introductionmentioning

confidence: 99%

Loose combined cutting seton for patients with suprasphincteric anal fistula: a randomized clinical trial protocol

et al. 2021

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Background: Suprasphincteric anal fistula is a type of high anal fistula. The traditional method of cutting seton (CS) has a high recurrence rate and can cause severe damage to the anal sphincter and anal incontinence. The combination of loose and cutting seton is a novel method developed on the basis of the traditional cutting seton technique, and has already been adopted by some clinicians in China. This study will examine the effectiveness and safety of the loose combined cutting seton (LCCS) technique for the treatment of suprasphincteric anal fistulas.Methods: This is a single-blinded randomized controlled trial conducted in the Anorectal Department of the China-Japan Friendship Hospital. A total of 76 patients diagnosed with suprasphincteric anal fistula will be randomly divided into two groups. One group will be treated with the LCCS method (the LCCS group; n=38) and the other group will be treated with the traditional CS method (the CS group; n=38).There will be 3 intervention periods, including the screening period, the surgical treatment period, and the postoperative follow-up period. Postoperative follow-up will be carried out on days 3, 5, 7, 14, 21, 28, 90, 180, and 365 after the operation. The main outcome measures are the complete cure rate of postoperative wounds and fistulas, the long-term recurrence rate, and evaluation of postoperative anal function (Wexner anal function assessment and anal function questionnaire). The secondary outcomes are the visual analogue scale (VAS) score for postoperative pain, pressure measurements of the anal canal and rectum before and after treatment, and the incidence of adverse events. All statistical results will be analyzed using the SPSS software 21.0 version. P values <0.05 will be considered statistically significant.Discussion: This research introduces a novel method for the treatment of suprasphincteric anal fistulas.The LCCS method will be compared with the traditional CS method in terms of safety and efficacy. If the LCCS technique is a safe and effective treatment for suprasphincteric anal fistula, its clinical application should be promoted.

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“…In order to efficiently assist patients with HAF and improve their QOL, the development of treatment methods with high rates of healing and low rates of recurrence, incontinence, and pain is warranted. Our previous retrospective study showed that loose combined cutting seton (LCCS) was effective for HAF patients, with high cure rate, low rate of incontinence, and less pain (19). In this study, we aim to observe the long-term effectiveness of LCCS in these patients.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up study of loose combined cutting seton surgery for patients with high anal fistula

Zhi¹,

Huang²,

Liu³

et al. 2021

Ann Transl Med

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Background: The treatment of high anal fistula (HAF) is still difficult for clinical surgeons. Our previous study demonstrated the short-term benefit of loose combined cutting seton (LCCS) for patients with HAF.This study aimed to evaluate the long-term effectiveness of LCCS for treating HAF patients.Methods: We retrospectively enrolled consecutive HAF patients who received LCCS therapy in our hospital between March 2014 and July 2017. After enrollment, all patients were followed up by clinical review. The patients' clinical information and most recent follow-up results were collected. Pain was assessed by the visual analog scale (VAS), and the severity of fecal incontinence was assessed by the Wexner Continence Grading Scale. We also assessed the patients' quality of life (QOL) using a the MOS item short from health survey (SF-36) questionnaire. HAF healing was considered the primary outcome, while the fistula recurrence rate, severity of fecal incontinence, and QOL were the secondary outcomes.Results: In total, 22 patients (18 male, four female) were enrolled in the final analysis. The mean duration of follow-up was 3.65 years (interquartile range: 3.55-4.22; range, 3.50-5.43). All patients were cured and there was no recurrence during the follow-up period. Eight patients reported a Wexner score of 1, while the remaining patients reported a score of 0 at the final follow-up. Furthermore, one patient had a VAS score of 1, while the remaining patients had a VAS score of 0, which indicated almost no postoperative pain. The QOL of all patients improved significantly.Conclusions: LCCS is an effective method to treat HAF patients. Large, multicenter randomized controlled trials are warranted.

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Loose combined cutting seton for patients with high intersphincteric fistula: a retrospective study

Cited by 14 publications

References 24 publications

The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Loose combined cutting seton for patients with suprasphincteric anal fistula: a randomized clinical trial protocol

Long-term follow-up study of loose combined cutting seton surgery for patients with high anal fistula

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