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

Table 1 Comparison of baseline characteristics, mean ± SD/%

Characteristic	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Age (years)	42.3 ± 8.4	42.7 ± 8.8	0.21	> 0.05
Gender (male/female)	47/13	46/14	0.12	> 0.05
Disease duration (months)	18.5 ± 5.6	18.2 ± 5.4	0.32	> 0.05
Fistula type (single/multiple)	20/40	22/38	0.24	> 0.05
Comorbidities (yes/no)	15/45	14/46	0.15	> 0.05
Average	7.2 ± 1.5	6.8 ± 1.4	0.36	> 0.05
Preoperative anal function score (Wexner score)	2.1 ± 0.6	2.0 ± 0.5	0.22	> 0.05
Postoperative complications rate	20	10	1.53	< 0.05
Postoperative hospital stays (days)	7.5 ± 2.0	6.0 ± 1.5	1.84	< 0.05
Postoperative anal function score (Wexner score)	3.5 ± 1.0	2.5 ± 0.8	1.71	< 0.05
Treatment satisfaction	75	85	1.62	< 0.05
Recurrence rate during follow-up	15	5	1.95	< 0.05

Table 2 Time-comprehensive comparison of postoperative outcomes, mean ± SD

Characteristic	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Postoperative pain score (0-10 scale)	6.5 ± 1.2	4.2 ± 1.0	1.95	< 0.001
Postoperative infection rate (%)	20	10	1.51	< 0.05
Postoperative quality of life score (quality of life, 0-100 scale)	65 ± 10	75 ± 9	2.02	< 0.001
Postoperative follow-up duration (months)	6 ± 1	6 ± 1	0.11	> 0.05
Postoperative sexual function score (0-10 scale)	7.0 ± 1.5	8.0 ± 1.2	1.61	< 0.05
Postoperative bowel function score (0-10 scale)	6.0 ± 1.0	7.5 ± 0.8	1.92	< 0.05

Table 3 Healing time and recovery indicator analysis, mean ± SD

Characteristic	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Complete healing time (days)	28.3 ± 5.8	21.5 ± 4.2	2.35	< 0.001
Anal function recovery time (days)	19.7 ± 4.5	14.2 ± 3.1	2.48	< 0.001
Wound epithelialization time (days)	25.1 ± 4.9	18.8 ± 3.6	2.61	< 0.001
Time to first ambulation (hours)	18.4 ± 3.2	12.6 ± 2.8	2.14	< 0.001
Time to normal diet resumption (days)	4.8 ± 1.6	2.9 ± 1.1	2.31	< 0.001
Time to first painless defecation (days)	8.7 ± 2.4	5.3 ± 1.9	2.67	< 0.001
Time to complete discharge cessation (days)	15.2 ± 4.1	10.8 ± 3.2	2.05	< 0.001
Time to return to work (days)	21.6 ± 6.3	16.4 ± 4.7	1.98	< 0.01

Table 4 Comparison of surgical-related indicators, mean ± SD/%

Indicator	Conventional group (n = 62)	Optimized group (n = 70)	Statistic	P value
Operation time (minutes)	38.7 ± 6.9	45.2 ± 8.3	t = 1.89	0.034
Intraoperative blood loss (mL)	18.7 ± 5.8	15.3 ± 4.2	t = 1.76	0.041
Complete fistula closure rate	0.871 (54/62)	0.957 (67/70)	χ² = 2.12	0.035
Anesthesia duration (minutes)	52.3 ± 8.1	58.6 ± 9.4	t = 1.74	0.044
Intraoperative fistula tract identification rate	0.919 (57/62)	0.986 (69/70)	χ² = 2.31	0.021
Seton placement success rate	0.887 (55/62)	0.971 (68/70)	χ² = 2.45	0.008

Table 5 Medication use and treatment compliance analysis, mean ± SD

Characteristic	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Postoperative analgesic use (days)	6.2 ± 2.1	3.8 ± 1.2	t = 2.74	< 0.001
Antibiotic use duration (days)	7.3 ± 2.4	4.1 ± 1.5	t = 2.89	< 0.001
Treatment compliance rate	0.903 (56/62)	0.971 (68/70)	χ² = 1.98	0.048
Total medication cost (dollars)	286.4 ± 54.7	198.3 ± 41.2	t = 2.56	< 0.001
Medication-related adverse events	0.161 (10/62)	0.071 (5/70)	χ² = 2.23	0.026
Patient-reported medication satisfaction (0-10)	6.8 ± 1.4	8.2 ± 1.1	t = 2.41	< 0.001
Medication dose adjustment times	2.7 ± 1.3	1.4 ± 0.8	t = 2.18	0.003

Table 6 Comparison of postoperative complications, n (%)

Complication type	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Wound infection	8 (13.3)	4 (6.7)	0.67	0.21
Mild anal incontinence	7 (11.7)	0 (0.0)	1.17	< 0.05
Others	3 (5.0)	1 (1.7)	0.50	0.32
Postoperative bleeding	5 (8.3)	2 (3.3)	0.83	0.24
Urinary retention	6 (10.0)	3 (5.0)	1.00	0.35
Prolonged pain duration	10 (16.7)	4 (6.7)	1.67	< 0.05
Recurrence	9 (15.0)	3 (5.0)	1.50	< 0.05
Extended hospital stays	7 (11.7)	2 (3.3)	1.17	< 0.05
Medication dependence	12 (20.0)	5 (8.3)	1.20	< 0.05
Infection (other than wound)	4 (6.7)	1 (1.7)	0.67	0.18
Psychological issues	5 (8.3)	2 (3.3)	0.83	0.24

Table 7 Comprehensive comparison of postoperative outcomes and quality of life, n (%)

Characteristic	Conventional treatment group (n = 62)	Optimized treatment group (n = 70)	Statistical value	P value
Patient satisfaction			χ² = 12.35	< 0.001
Very satisfied	40 (64.5)	59 (84.3)
Satisfied	18 (29.0)	11 (15.7)
Dissatisfied	4 (6.5)	0 (0)
Complete work/Life recovery	0.839 (52/62)	0.957 (67/70)	χ² = 2.15	0.032
Long-term quality of life score (0-100)	72.3 ± 8.4	83.6 ± 6.2	t = 2.67	< 0.001
Patient treatment recommendation rate	0.710 (44/62)	0.929 (65/70)	χ² = 2.84	< 0.001
Repeat surgery requirement	0.081 (5/62)	0.014 (1/70)	χ² = 2.32	0.020
Return to normal social activities	0.790 (49/62)	0.943 (66/70)	χ² = 2.41	0.008