ORIGINAL RESEARCH article
Front. Physiol.
Sec. Clinical and Translational Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1520260
Different tightening schemes in thread-drawing therapy on their effects on anal function recovery in patients with high simple anal fistula
Provisionally accepted
- Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, Hebei Province, China
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Objective: We aimed to compare the effects of different tightening schemes in thread-drawing therapy on the recovery of anal function in patients with high simple anal fistula after treatment.One hundred patients with high simple anal fistulas who met the inclusion criteria were randomly divided into four groups of 25 patients each. All patients underwent low-level incision and high-level thread-drawing surgery. In the 1/5, 1/4, 1/3, and1/2 groups, the rubber band cutting force was applied by tightening the surrounding muscle bundle to 1/5, 1/4, 1/3, and 1/2 of its circumference, respectively (using a graduated rubber band). Subsequent tightenings were also performed to the corresponding fractions of the circumference. The overall clinical efficacy, wound healing time, wound symptom score, anal function, and Wexner score were compared in the four groups.Results: The 1/5 group had the longest wound healing time, longer than those of the 1/4, 1/3, and 1/2 groups (P < 0.05). On the 7 th postoperative day, the 1/2 group had a higher wound symptom score than the 1/5, 1/4, and 1/3 groups (P < 0.05). Three months after surgery, patients in the 1/5 group had higher resting anal canal pressure and maximum anal canal systolic pressure than the other three groups; the 1/4 and 1/3 groups had higher values than the 1/2 group (P < 0.05). One month and three months after surgery, patients in the 1/2 group had the highest Wexner scores, higher than those in the 1/5, 1/4, and 1/3 groups (P < 0.05).Tightening schemes of 1/4 and 1/3 were found to be optimal, as they resulted in less postoperative pain and minimal impact on anal function.
Keywords: High simple anal fistula, Precise thread-drawing therapy, Influencing factors, Anal function function, Wound symptom score, anorectal pressure, Wexner score
Received: 31 Oct 2024; Accepted: 29 May 2025.
Copyright: © 2025 Zhao, Wang, Song, Yuan, Yang, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pengfei Zhao, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, Hebei Province, China
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