To observe the efficacy and safety of modified TROPIS combined with catheter drainage in the treatment of complex anal fistula.

Clinical data of 100 patients with complex anal fistula (or abscess) hospitalized in The Anorectal Center of Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from April 2019 to October 2020 were retrospectively analyzed. According to different surgical methods, they were divided into treatment group (modified TROPIS combined with catheter drainage, n=52) and the control group (cutting seton, n=48). The operation time, intraoperative blood loss, pain score (1, 3, 7 days) after operation, wound area (on the day of surgery, postoperative 7 days, 14 days) after operation, wound healing time, anal Wexner score (3 months) after operation, anal canal resting pressure, anal canal maximum systolic blood pressure (3 months) after operation, postoperative complications, clinical efficacy and relapse were compared between the two groups.

There were no significant differences in anal Wexner score and recurrence rate between 2 groups 3 months after surgery (all P＞0.05). The operation time of the treatment group was shorter (t=5.473, P＜0.05), the amount of intraoperative blood loss was less (t=5.426, P＜0.05), and the pain score at different postoperative points (1st, 3rd and 7th day) of the treatment group were lower than that of the control group (t=5.873, 6.665, 2.162; P＜0.05), the wound area at different time points was smaller than that in the control group (t=40.744, 40.154, 42.535; P＜0.05), the wound healing time was shorter than that of the control group (t=14.356, P＜0.05), the complications of postoperative dysuria were less than that of the control group (χ²=4.537, P＜0.05), and the total incidence of complications was lower than that of the control group (χ²=8.310, P＜0.05). The anal canal resting pressure and maximum anal systolic pressure 3 months after operation were higher than those in the control group (t=2.348, 2.180; P＜0.05), the total effective rate 3 months after operation was higher than that of control group (Z=4.947, P＜0.05).

Compared with suture incision, modified TROPIS combined with catheter drainage in the treatment of complex anal fistula can shorten the operation time, reduce intraoperative bleeding, relieve postoperative anal pain, shorten wound healing time, reduce postoperative complications, and better protect anal function while ensuring curative effect.