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Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition) ›› 2024, Vol. 18 ›› Issue (05): 303-308. doi: 10.3877/cma.j.issn.1674-1358.2024.05.007

• Short Research Articles • Previous Articles     Next Articles

Prognostic impact of human immunodeficiency virus infection on patients with anal fistula undergoing incision-thread-drawing surgery

Qiqiu Xiong1, Huichun Xing2, Baoliang Li1, Yang Wang1, Zhe Jia1, Ke Zhang1, Ronghai Huang1, Li Jiang1,()   

  1. 1.Department of General Surgery, Capital Medical University, Beijing 100015, China
    2.Center of Liver Diseases Division 3, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  • Received:2024-04-15 Online:2024-10-15 Published:2024-12-13
  • Contact: Li Jiang

Abstract:

Objective

To explore the impact of human immunodeficiency virus (HIV) infection on the prognosis of anal fistula patients undergoing incision and thread drawing surgery, and to provide reference for the standardized clinical diagnosis and treatment of anal fistula patients with HIV infection.

Methods

Total of 85 patients with anal fistula who underwent incision and thread drawing surgery in Beijing Ditan Hospital, Capital Medical University from January 2014 to January 2019 were selected, including 40 HIV infected patients (HIV infected group) and 45 non-HIV infected patients (control group), gender, age, anal fistula classification, thread hanging status, postoperative pain, healing status and recurrence rate within oneyear of surgery in two groups of patients were analyzed to evaluate the short-term and long-term efficacy. The quantitative data were analyzed by independent sample t-test and Mann Whitney U test; the counting data was analyzed by chi-square test. The risk factors for anal fistula recurrence were analyzed by univariate analysis and multivariate Logistic regression analysis.

Results

There was no difference in postoperative defecation recovery time [2 (1, 2) d vs. 2 (1, 2) d:Z =-0.245, P = 0.806)], VAS score on the first day after surgery [3(2, 4) points vs. 3 (3, 5) points: Z =-0.862, P = 0.389)], hanging line detachment time [22 (19, 24.25) d vs. 24 (20, 28) d:Z =-1.938, P = 0.053], and healing time [(28.88 ± 3.41) d vs. (29.73 ± 2.45) d: t = 1.319, P =0.192)] between HIV infected group and control group. The recurrence rate of anal fistula in HIV infected patients within one year was 32.5% (13/45), significantly higher than that of control group (11.1%, 5/40), with significant difference (χ2 = 5.80, P = 0.02). Logistic regression analysis showed that HIV infection (OR = 4.756,95%CI:1.442-15.683, P = 0.010) and healing time (OR = 1.249, 95%CI:1.027-1.518, P = 0.026) were both influencing factors for recurrence within one year after undergoing anal fistula incision and thread drawing surgery.

Conclusions

HIV infection has no significant effect on short-term recovery of patients with anal fistula who undergo incision and thread drawing surgery. HIV infection and longer healing time significantly increase the recurrence rate of anal fistula in patients within one year.

Key words: Anal fistula, Incision-thread-drawing procedure, Human immunodeficiency virus

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