Enhanced surgical management of complex anal fistulas via integrated traditional Chinese medicine: A retrospective cohort study.

BACKGROUND: Our research aimed to enhance treatment approaches for difficult anal fistula patients via classical Chinese surgical techniques and assess their healing results by examining past cases. AIM: To compare the clinical effectiveness and safety of traditional Chinese medicine-integrated surgery with traditional seton-based care for patients with complicated anal fistulas. METHODS: To assess the safety and therapeutic effectiveness of surgical treatment combined with traditional Chinese medicine with traditional seton-based management for patients with complicated anal fistulas. The standard care group (62 patients) received usual surgical care, including regular seton drainage and fistula cutting procedures. The 70 patients in the enhanced care group underwent specialized Chinese surgical therapy that included the transanal opening of intersphincteric space technique for high muscle-crossing fistulas, personalized set-on techniques, and auxiliary therapies such herbal steam treatments and washing. Our study compared healing success, wound closure time, sphincter function preservation, and after-surgery problems between these groups. RESULTS: The improved care group achieved 90.0% overall success, which was notably better than the 78.8% overall success rate of the standard care group (P < 0.05). Wounds healed in approximately 21.2 days with improved care compared with 29.5 days with standard care (P < 0.01). Later checkups revealed that the improved group maintained better sphincter control and had fewer complications (6.0% compared with 15.0% in the standard group, P < 0.05). CONCLUSION: When treating challenging anal fistulas, the improved Chinese surgical technique undoubtedly improves healing results, recovery times, and post-operative complications while preserving improved bowel control.