The Use of Rectal Suppositories With Streptokinase and Streptodornase in the Treatment of Anal Fistulas With Extensive Inflammatory Infiltration

Background: Anal fistulas with extensive inflammatory infiltration pose significant challenges in treatment, often leading to prolonged hospital stays, complications, and reduced quality of life. This study evaluates the efficacy of rectal suppositories containing streptokinase (15,000 IU) and streptodornase (1,250 IU) as an adjunct to standard therapy. Methods: A prospective randomized controlled trial was conducted from January 2018 to December 2019 at Weihaiwei People's Hospital. One hundred and ten patients with anal fistulas and extensive inflammatory infiltration were divided into two groups: Group 1 (n=55) received standard treatment per international guidelines, while Group 2 (n=55) received the same plus rectal suppositories. Suppositories were administered based on disease severity: for severe cases, 1 suppository three times daily for 3 days, twice daily for 3 days, and once daily for 3 days; for moderate/mild cases, twice daily for 3 days, then once daily for 4 days or twice daily for 2 days. Outcomes included hospital stay duration, severe disease incidence, complications, pain syndrome (via Visual Analog Scale, VAS), and quality of life (QoLAF-Q). Results: Group 2 showed significantly shorter hospital stays (mean 12.4 ± 3.2 days vs. 18.7 ± 4.5 days, p<0.001), fewer severe cases (14% vs. 36%, p<0.01), fewer complications (9% vs. 25%, p<0.05), lower VAS scores, and improved QoLAF-Q scores compared to Group 1. Conclusions: Adjunctive use of streptokinase-streptodornase suppositories enhances treatment efficacy, reduces morbidity, and improves patient outcomes in anal fistulas with inflammatory infiltration.