The aim of this study was to further analyze the efficacy and safety of three-cavity clearance (TCC) in the treatment of glandular perianal abscesses, explore the risk factors for postoperative anal fistula and perianal abscess recurrence, and build a prediction model to increase the success rate of TCC in treating perianal abscesses. Clinical data were collected from patients who underwent TCC at the Second Affiliated Hospital of Nanjing University of Chinese Medicine from January 2018 to January 2024. Risk factors for perianal abscess recurrence and anal fistula after TCC were analyzed using univariate and multivariate logistic regression. A predictive nomogram model was established on the basis of independent risk factors, and its predictive performance was evaluated. Additionally, risk function curves were used for postoperative anal fistula and abscess recurrence across different abscess locations with statistical significance assessed via log-rank tests. A total of 308 patients were included from January 2018 to January 2024, with an average follow-up time of 37.9 ± 16.8 months. The postoperative fistula rate was 4.9%, and the abscess recurrence rate was 8.1%. One patient reported occasional fluid leakage after the operation, with a Wexner score of 1 point. The total success rate was 87.0%. Logistic regression analysis revealed that the abscess site, combined diabetes, nutritional status and history of abscess surgery were risk factors for recurrence and anal fistula formation after TCC (p < 0.05). The area under the receiver-operating characteristic curve (ROC) curve was 0.889 (95% CI 0.82–0.95), and the specificity and sensitivity were 95.5% and 75%, respectively. TCC for perianal abscess can significantly increase the success rate of treatment and reduce the postoperative fistula rate and abscess recurrence. The abscess site, combined diabetes, nutritional status, and history of abscess surgery are independent risk factors for fistula and abscess recurrence after TCC. Current research implies that TCC is a safe and effective surgery for perianal abscess and is worthy of further study and application.
Xuan et al. (Thu,) studied this question.