Hemorrhoids, anal fissures, and anal fistulas are common anal diseases, but anal fistula surgery is sometimes traumatic, especially high anal fistulas and complex anal fistulas are difficult points in surgical treatment.
Conference initiator: Huang Ping
Conference Convenor: Ni Chunhua
Conference organizers: Ni Chunhua, Dai Qingsong, Wu Zuoyou, Zhang Weiwei, Chen Qi, Zhou Beisheng, Luan Haifei, Weng Heyu, Hang Qiuju, Shao Lu, Zhao Qingyun, Chen Lili, Liang Longxiao, Wang Longfen, Wang Xinru, Zhang Dandan, Liu Hui, Li Juan, Zhao Qian, Hua Yuting, Yang Kun, Wang Yao, Xu Huilin, Chen Shu
For high anal fistulas, Professor Zheng Lihua took the lead in incising the anal sphincter tissue below 1 cm above the dentate line, and penetrating the intestinal wall at the top of the lacuna through the method of thread-hanging (tied with four No. 7 threads). Surprisingly, it solved the problems of large trauma and easy injury of anal sphincter in domestic and foreign anal fistula surgery.
In the treatment of complex anal fistulas between or through the sphincter, there are many fistulas and the internal mouth is secret. The surgeon finds the surgical treatment very difficult. The surgical community believes that the primary lesion of anal fistula is anal gland infection, which is located 1 cm above and below the dentate line, between the mucous membrane and the external sphincter.
Dr. Huang Ping believes that no matter how complicated the anal fistula is (except for Crohn's disease), the primary lesion is still anal gland infection. Dr. Huang Ping uses total anal gland resection to treat complex anal fistulas, that is, all the diseased tissues (including anal glands) between the mucous membrane and the external anal sphincter are removed, with satisfactory results.
Professor Song Huayu pointed out that rectovaginal fistula is a difficult point in surgical treatment, especially the following three:
(1) Rectovaginal fistula caused by anal fistula,
(2) Rectovaginal fistula caused by Crohn’s disease,
(3) Recto-vaginal fistula caused by radiotherapy.
Professor Song Huayu is the first in China to use pudendal flap transplantation combined with modified Bacon surgery to treat rectal-vaginal fistulas. This technology is leading domestically. Professor Song Huayu proposed that the transplanted pudendal flap can be 15 cm long and 8 cm wide, and the root of the flap does not have to show the pedicled blood vessel.
Leave a refreshing impression on the participants.