Advances in proctology

Abstract

In recent years there has been progress in proctological diagnostics and minimally invasive procedures. We present the latest diagnostic options in proctology, including dynamic 3D anorectal ultrasonography technique, the so-called echodefecography, as well as volume render mode, a technique based on computer processing of ultrasound images. The current state of knowledge on the treatment of the most common proctological diseases: haemorrhoidal disease, anal fistula, anal fissure, stool incontinence, rectal prolapse and pilonidal sinus, was also presented. According to the available analyses, patients are most interested in maintaining full postoperative gas and stool continence, while the effectiveness of the surgery comes second. Modern surgery meets these expectations by developing preoperative diagnosis and minimally invasive techniques which do not cause sphincter damage. Indications for the use of these methods, their limitations, and possible postoperative complications were discussed. There is still some room for classical surgical techniques, which have been enriched with methods supporting the healing of difficult healing wounds and inflammation of the anorectal region: negative pressure wound therapy systems and hyperbaric chambers.