Abstract
PURPOSE. Examine the results of surgical treatment of fistulas of the anus and rectum. MATERIALS AND METHODS. Generalized material surgical treatment of 53 patients with different types of fistulas of the anus and rectum during the period 2010-2015. based coloproctological DRKTMU center. We used clinical, laboratory and instrumental methods of investigation according to generally accepted standards of coloproctology. RESULTS. We used an individualized approach, which, along with the known operations: seton, Gabriel-1, Gabriel-2, and used more modern methods of radical surgical procedures, taking into account «case» building the wall of the rectum: 1) muco-submucosal flap; 2) muco-muscular flap (consisting of mucosal and submucosal layers and inner circular smooth muscle layer of the gut). Methods of radical plastic surgery were performed in 39 (73,6%) patients with transsphincteral and extrasphincteral fistulas. Among them by the method of V.M.Maslyak (1990) - 18 (34,0 %) patients and mucosalflap according to the technique developed in the clinic - 21 (39.6%) patients. Patients satisfactorily suffered an intervention. In 4 (7,6 %) patients the disease recurred. Among them in 1 patient after 3 weeks and in 3 patients after 2-3 months after the intervention the recurrence of disease was detected. Of these in 2 (3,8 %) patients was detected transsphincteral fistulae and in 2 (3,8 %) -extrasphincteral rectumfistulas. Patients with recurrent fistulas were reoperated. CONCLUSION. The results indicate the feasibility of application in surgical proctology transanal plastic interventions with the movement of mucous-submucosal or mucosal-muscle flap from the known and improved our procedures.
Highlights
Laboratory and instrumental methods of investigation according to generally accepted standards of coloproctology
We used an individualized approach, which, along with the known operations: seton, Gabriel-1, Gabriel-2, and used more modern methods of radical surgical procedures, taking into account «case» building the wall of the rectum: 1) muco-submucosal flap; 2) muco-muscular flap
Among them by the method of V.M.Maslyak (1990) – 18 (34,0 %) patients and mucosal flap according to the technique developed in the clinic – 21 (39.6 %) patients
Summary
Vasilenko L.I., Shalamov V.I., Polunin G.E., Gulmamedov V.A., Volkov V.I., Likov V.A., Tanasov I.A., Gerasimenko Y.A., Fedorchuk O.N. Generalized material surgical treatment of 53 patients with different types of fistulas of the anus and rectum during the period 2010-2015. Из более современных способов хирургического лечения СЗП и СПК с применением высокотехнологичного оборудования, биологических или биосовместимых материалов заслуживают внимания [7] следующие: 1) операция (LIFT) [12] – перевязка свищевого хода в межсфинктерном пространстве; 2) видеоассистируемые вмешательства с использованием фистулоскопа (VAAFT) [10,11]; 3) ликвидация СЗП и СПК с помощью биологических герметизирующих тампонов (PLUG) [10,11]; 4) введение в свищевой ход различных композитных составов (фибриновый клей – через наружное отверстие), улучшающих регенерацию и заживление в сочетании с закрытием внутреннего свищевого отверстия перемещенным лоскутом стенки прямой кишки с целью снижения рецидива [9]. В клинике общей хирургии No 1 ДонНМУ, которая является областным колопроктологическим центром в Донбассе, в последние годы отдают предпочтение слизисто-подслизистому и слизисто-подслизисто-мышечному лоскутам, при низведении которых осуществляют пластическое закрытие внутреннего свищевого отверстия прямой кишки
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
