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Three-cavity clearance (TCC) can decrease the fistula rate after drainage of a perianal abscess: a case-control

Heiying Jin1, Yan Chen2, Bei Zhang3

  • 1Department of Colorectal Surgery, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Gastroenterology Report
|August 29, 2018
PubMed
Summary
This summary is machine-generated.

Three-cavity clearance (TCC) for perianal abscesses is safe and effective, significantly reducing fistula rates compared to simple drainage. This sphincter-preserving method shows promise for clinical practice.

Keywords:
Three-cavity clearance (TCC)anal fistulacutting setondrainageperianal abscess

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Area of Science:

  • Colorectal Surgery
  • Surgical Innovation
  • Perianal Disease Management

Background:

  • Perianal abscesses are common and can lead to complications like fistulas.
  • Current treatment options have varying success rates and complication profiles.
  • Minimally invasive techniques are sought to improve outcomes and preserve anal function.

Purpose of the Study:

  • To evaluate the safety and efficacy of three-cavity clearance (TCC) for treating perianal abscesses.
  • To compare TCC outcomes with simple incision and drainage and radical abscess incision with seton placement.
  • To assess fistula formation, anal incontinence, wound healing, and hospital stay.

Main Methods:

  • A case-control study involving 138 patients with perianal abscesses.
  • 46 patients underwent three-cavity clearance (TCC).
  • Comparison groups included simple incision and drainage (46 patients) and abscess drainage with cutting seton (46 patients).

Main Results:

  • The fistula rate in the TCC group was 13.0%, significantly lower than simple incision and drainage (39.1%, p<0.01).
  • Fistula rates were similar between TCC (13.0%) and radical abscess incision (8.7%, p>0.05).
  • No anal incontinence was observed in the TCC or simple incision and drainage groups; two patients in the radical abscess incision group experienced incontinence.

Conclusions:

  • Three-cavity clearance (TCC) is a safe and effective sphincter-preserving procedure for perianal abscesses.
  • TCC can decrease the fistula rate following perianal abscess drainage.
  • TCC represents a valuable clinical method, warranting further investigation.