肛瘘手术的选择.ppt

浙江省中医院 徐利;presacral tumor Mucinous Adenocarcinoma hidradenitis suppurativa infected inclusion cysts pilonidal disease Bartholin gland abscess in females ; ; Complex fistulas high transsphincteric fistulas with or without a high blind tract, suprasphincteric extrasphincteric fistulas, horseshoe fistulas, and those associated with inflammatory bowel disease, radiation, malignancy, preexisting incontinence, or chronic diarrhea, anterior sphincter complex in women---2011Practice Parameters for the Treatmentof Perianal Abscess andFistula-in-Ano (Revised) track crosses 30 to 50 percent of the external sphincter (high-transsphincteric, suprasphincteric,and extrasphincteric), is anterior in a female, has multiple tracks, is recurrent, or the patient has preexisting incontinence, local irradiation, or Crohn’s disease---2005Practice Parameters for the Treatmentof Perianal Abscess andFistula-in-Ano (Revised) ; ;经典的Parks分型; 肛瘘分型与马蹄形肛周脓肿的引流 ; 括约肌间瘘的走形; 括约肌间瘘的走形 ; 经括约肌瘘的走形 ; 括约肌上瘘与括约肌外瘘 ;括约肌间型（1）;经括约肌型（1）;经括约肌型（2）;*;括约肌外型（1）; ;;Baby mixter;Custom made narrow blade retractors; ; ; ; ; ; ; ; ; ; lay-open fistulotomy or fistulectomy submucosal intersphincteric low trans-sphincteric. anterior fistulas in women × ; Anorectal advancement flap anterior fistulas in women inflammatory bowel disease high transsphincteric suprasphincteric fistulas previous multiple sphincter operations multiple and complex fistulas; Seton placement lay-open technique +seton cutting seton ACGBI--cutting seton be used only for low transsphincteric fistula or as the secondary treatment for a low transsphincteric fistul