Retrospective analysis of medical records of patients with postoperative scarring deformities of the perianal area for the period 2011-2021

Abstract

surgical interventions in the perineal area account for a significant proportion of all colorectal operations. Thus, the problem of postoperative scar deformities of the perianal area has been the cause of scientific discussions for many years and remains relevant today. The reason for this is the lack of described clear approaches to the choice of treatment tactics in different clinical situations. That is why the aim of our study is to establish the relationship between clinical and anamnestic data and the choice of treatment methods for patients with postoperative scar deformities. We analyzed the medical records of 214 patients who were diagnosed with postoperative scar deformities. These patients were treated during 2011-2021 in the proctology department of the "Kyiv City Clinical Hospital No. 18". In order to facilitate the presentation of the results of the analysis, we formed 2 groups depending on the method of treatment: the first group included 78 (36.44%) patients who were treated with non-surgical methods; the second group included 136 patients (63.56%) who underwent surgical treatment. First of all, we made a comparison by gender and found that women are probably more prone to the formation of postoperative scar deformity. Also, a possible link between the duration of the disease and the choice of treatment method was found, which was shorter in group 1 compared to group 2. The main complaints of the patients were as follows: stool retention, inability to defecate without enemas, pain during defecation. According to the status localis description, it was found that anal stricture was present in 71 patients in group 1 (91.03%) and 86 (63.24%) in group 2. Regarding the method of treatment, only conservative treatment was performed in 24 patients (11.21%), bougienage - in 54 patients (25.23%), alloplasty - in 59 patients (27.57%), sphincterolevatoroplasty - in 34 patients (15.89%), and combined interventions - in 43 patients (20.09%). It was also found that in 12 cases (5.61%) patients were re-hospitalized, most of them, namely 9 patients, were in-group 1. Therefore, it should be noted that there is a possible relationship between the duration of the disease, patient complaints and the choice of treatment, but a randomized trial is needed to prove this more accurately. It was also found that postoperative scarring deformities occur more often in women, and the most common causes are hemorrhoidectomy, surgical treatment of purulent-necrotic perineal diseases and combined surgical interventions.