A randomized controlled trial of a new procedure for the treatment of perianal abscesses, the Trans-intersphincteric Double Seton (TRISDS)

Abstract OBJECTIVE To study the clinical efficacy and safety of a novel procedure,Trans-intersphincteric Double Seton, for the treatment of perianal abscesses in the sciorectal hiatus. METHODS The study population consisted of patients with perianal abscess in the sciorectal space who underwent Trans-intersphincteric Double Seton (TRISDS) and perianal abscess Incision and Drainage (I&D) from September 2020 to September 2023 at the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine. The cure rate, hospitalization time, wound healing time, and Wexner score of anal function were observed in both groups after treatment. RESULTS 100 patients with perianal abscess received surgical treatment, of which 50 patients (male/female: 41/9, mean age: 32.98 years old) received Trans-intersphincteric Double Seton as the observation group, and the other 50 patients (male/female: 38/12, mean age: 32.76 years old) received Incision and Drainage of perianal abscess as the control group, and the differences in the basic data of the patients of the two groups were not significant in comparison (P>0.05) and they are comparable. The cure rate of the observation group 86%, higher than the control group 42%, (p < 0.05) the difference is statistically significant.hospitalization time of the observation group (7.02 ± 1.63) d is shorter than that of the control group (7.36 ± 1.64) d, the two groups (p > 0.05) are not statistically significant.the healing time of the observation group (33.26 ± 3.81) d is shoeter than that of the control group (37.68 ± 6.24) d, (p < 0.05) the two groups (p < 0.05) are comparable. ) d, (p < 0.05) the difference was statistically significant. Evaluation of anal function: Wexner score comparison between the two groups of patients, no anal incontinence, preoperative and postoperative 42 days comparison (p > 0.05), there is no statistical significance, 21 days after the operation, the observation group (1.82 ± 1.32) is higher than the control group (1.28 ± 1.20), the two groups (p < 0.05),the difference is statistically significant; CONCLUSION For the treatment of perianal abscess in the sciorectal space, transsphincteric double-hanging suture does not lead to anal incontinence as does incision and drainage, but transsphincteric double-hanging suture is safer and more effective, with a higher rate of healing, shorter healing time, and good protection of anal function, which is of clinical promotion value.