[Several problems needing attention in the diagnosis and treatment of common perianal benign diseases]

Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Dec 25;27(12):1213-1220. doi: 10.3760/cma.j.cn441530-20241012-00339.
[Article in Chinese]

Abstract

Hemorrhoids, anal fissure, anal fistula and perianal abscess are the most common benign diseases around the anus, which obviously affect people's life and work, and need to be well diagnosed and treated. Based on damage control, the treatment principle is to eliminate relevant disease symptoms and protect the anal function at the same time. Perianal benign diseases are common and frequently occurring, which can be diagnosed and treated in many non-specialist hospitals. Therefore, there is great heterogeneity in the level of diagnosis and treatment, and related complications may occur due to iatrogenic factors such as the selection of treatment strategies, resulting in certain medical risks and subsequent passive treatment. Conservative treatment of internal hemorrhoids at degree I-II and acute anal fissure can achieve good results; internal hemorrhoids at degree III-IV, external hemorrhoids, anal fistula and perianal abscess can only be cured by surgery. The surgeon should pay attention to the protection of anal pad tissue and sphincter function to prevent serious complications such as postoperative anal stenosis and defecation dysfunction. It is imperative to accurately evaluate the specific clinical characteristics of each patient, formulate individualized treatment plans, and combine multiple treatment approaches.

痔、肛裂、肛瘘和肛周脓肿等是肛门周围最常见病的良性疾病,明显影响人们生活和工作,需要得到良好的诊治。在控制损伤的基础上,消除相关疾病症状,同时保护好肛门功能是治疗原则。肛周常见良性疾病是常见病、多发病,可以在许多非专科医院诊治,所以诊疗水平存在很大异质性,可能因治疗策略选择等医源性因素发生相关并发症,造成一定医疗风险和后期治疗的被动。Ⅰ~Ⅱ度内痔和急性肛裂,经保守治疗可以取得良好的效果;Ⅲ~Ⅳ度内痔、外痔、肛瘘以及肛周脓肿必须通过手术治愈。手术要注重保护肛垫组织、括约肌功能,以防止术后肛门狭窄及控便功能障碍等严重并发症。建议术前应准确评估每例患者具体的病理特点,制定个体化的治疗方案,可以将多种技术手段进行联合应用。.

Publication types

  • English Abstract

MeSH terms

  • Abscess / diagnosis
  • Abscess / therapy
  • Anal Canal / physiopathology
  • Anus Diseases* / diagnosis
  • Anus Diseases* / therapy
  • Fissure in Ano / diagnosis
  • Fissure in Ano / therapy
  • Hemorrhoids* / diagnosis
  • Hemorrhoids* / therapy
  • Humans
  • Rectal Fistula* / diagnosis
  • Rectal Fistula* / therapy