Safety and efficacy of three-cavity clearance in the management of cryptoglandular perianal abscess: A multicentre randomized controlled study

Abstract

medRxiv preprint IF the manuscript is provisionally accepted, a VIDEO ABSTRACT will be required prior to final acceptance. 【ABSTRACT】 OBJECTIVE: To evaluate the safety and efficacy of three-cavity clearance in the management of cryptoglandular perianal abscess. METHOD: This was a multicentre randomized controlled study. The study was designed and approved by the ethics committee of the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. The study was registered in the Chinese Clinical Trial Register centre (ChiCTR1800016958).Patients with cryptoglandular perianal abscess in 5 Hospitals from Sept.2018 to Sept. 2019 were included.The anal fistula rate, anal incontinence, abscess recurrence, success rate, postoperative pain , wound healing time, and hospitalization duration were compared. RESULTS:Total 334 patients were enrolled in the study, who were 162 in the three-cavity clearance group and 172 in the control group. The anal fistula rate and abscess recurrence rate were 6.2% and 1.9% in the three-cavity clearance group (P=0.001) and 18.0% and 8.1% in the control group (P=0.009). No patients experienced fecal incontinence. The success rate in the three-cavity clearance group was 92.0% and that in the control group was 73.8% (P=0.00001). The postoperative pain on day 3 was lower in the three-cavity clearance group than that in the control group (P=0.002). The hospitalization duration was 9.0±5.4 days in the three-cavity clearance group and 10.4±6.1days in the control group (P=0.049). The wound healing time was 27.1±16.4 days in the three-cavity clearance group and 28.2±14.1 days in the control group (P=0.764). CONCLUSIONS:This randomized controlled study showed that three-cavity clearance is a safe and effective management of cryptoglandular perianal abscess.【 Keywords 】 perianal abscess, three-cavity clearance, simple incision and drainage, multicentre randomized controlled study