Abstract
AIM. To develop tactics of treatment for post-traumatic anal sphincter insufficiency in emergency surgery. MATERIALS AND METHODS. 472 patients with anal sphincter insufficiency were treated between 1977-2015. Of them 125 had conservative therapy. Surgical treatment was performed in 347 patients. Twenty-four patients had emergency procedure. RESULTS AND CONCLUSIONS. The success of the rehabilitation of these patients depends on the timely and adequate surgical care at the time of the sphincter injury. 3 degrees of perineum tears in labor should be sutured by experienced obstetricians and only in layers. Sphincteroplasty without colostomy is indicated within 24 hours after injury, while later admission ot hospital requires defunctioning stoma. Gunshot sphincter damage require wound debridement without sphincteroplasty and defunctioning stoma.
Highlights
ТАКТИКА ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПРИ ПОВРЕЖДЕНИЯХ АНАЛЬНЫХ СФИНКТЕРОВМуравьев А.В.,1,2 Линченко В.И.,Муравьев К.А.,1 Чумаков П.И.,1 Петросянц С.И.,2 Оверченко Д.Б.,2 Галстян А.Ш.,2 Ефимов А.В.3.
Пролечено 472 больных с недостаточностью анального сфинктера, как в плановом, так и в экстренном порядке.
Успех реабилитации этих больных во многом зависит от своевременной и адекватной хирургической помощи в момент повреждения сфинктера.
Summary
Муравьев А.В.,1,2 Линченко В.И.,Муравьев К.А.,1 Чумаков П.И.,1 Петросянц С.И.,2 Оверченко Д.Б.,2 Галстян А.Ш.,2 Ефимов А.В.3. Пролечено 472 больных с недостаточностью анального сфинктера, как в плановом, так и в экстренном порядке. Успех реабилитации этих больных во многом зависит от своевременной и адекватной хирургической помощи в момент повреждения сфинктера. При бытовой травме сфинктера и поступлении в стационар до 24 часов, возможно выполнение сфинктеропластики без колостомы, после 24 часов – только с превентивной колостомой. Огнестрельные повреждения сфинктера нуждаются в хирургической обработке раны без сфинктеропластики и с обязательным наложением стомы. To develop tactics of treatment for post-traumatic anal sphincter insufficiency in emergency surgery. 472 patients with anal sphincter insufficiency were treated between 1977-2015. The success of the rehabilitation of these patients depends on the timely and adequate surgical care at the time of the sphincter injury. Gunshot sphincter damage require wound debridement without sphincteroplasty and defunctioning stoma. [Keywords: post-traumatic anal sphincter insufficiency, sphincteroplasty, surgical tactics]
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