Two-Fingers digital rectal examination for anal diseases: protocol of a prospective, diagnostic study

AbstractPurpose Anal fistula is an anorectal infectious disease caused by perianal abscess or perianal disease. Surgery is the main treatment method for anal fistula. Accurate anorectal examination is of great significance to reduce the missed diagnosis rate of anal fistula, especially the misdiagnosis of anal fistula with no clear external opening. Two-Fingers digital rectal examination (TF-DRE) is a method improved by Professor Zheng Lihua on the basis of traditional digital anus examination. It has been used since 2012 and has accumulated a lot of clinical experience. However, there is a lack of comprehensive research on the value of TF-DRE for the diagnosis of anal fistula. The main purpose of this study is to compare the difference in the diagnostic value of TF-DRE, traditional digital rectal examination, and anorectal ultrasonography in the diagnosis of anal fistula. Methods For patients who met the inclusion criteria, TF-DRE was performed to explore the number and location of the external orifice, internal orifice, the number of fistula and the relationship with the perianal sphincter, as well as the data recorded by digital rectal examination and anorectal ultrasonography To make a comparison, the final diagnosis results from clinicians during the operation was taken as the gold standard, the diagnostic accuracy of TF-DRE for anal fistula is calculated, and the significance of TF-DRE in the preoperative diagnosis of anal fistula is studied and analyzed. All statistical results were analyzed using SPSS22.0, and P < 0.05 indicated that the difference was statistically significant. Conclusion The research protocol details the advantages of TF-DRE compared with digital rectal examination and anorectal ultrasonography in the diagnosis of anal fistula, and provides clinical evidence for the diagnostic value of TF-DRE in anal fistula. As an innovative anorectal examination method, there is still a lack of high-quality research using scientific methods in the current literature. This study will provide rigorously designed clinical evidence for TF-DRE.