Abstract
The anal fissure and the sacrococcygeal sinus in the structure of coloproctological pathology take third and fourth places after hemorrhoids and paraproctitis. The results of their treatment do not satisfy coloproctologists: the frequency of postoperative complications and relapses of the disease is high, rough scars and discomfort in the area of surgical intervention are formed. Aim - to improve the treatment results of patients with sacrococcygeal sinus and anal fissure. Materials and methods: 152 patients were operated on: 79 (52.0%)-with a sacrococcygeal sinus in the stage without clinical manifestations and 73 (48.0%) – with a chronic anal fissure. In addition to the standard laboratory and instrumental examination, the following were studied: predisposition to the development of excessive scarring; anal sphincter contractility. The importance of acute-phase inflammatory proteins in predicting the pathological scars formation was studied; measures were taken to prevent their occurrence. Surgical treatment methods of the sacrococcygeal sinus using an intradermal suture are proposed. Result. Long-term results comparison of traditional treatment patients with uncomplicated sacrococcygeal sinus and an integrated approach, a decrease was revealed: the development of gross scar deformation in the surgical intervention area – by 2.7 times; discomfort in the sacrococcygeal region - by 3.7 times, the number of relapses of the disease – by 2.4 times. In the chronic anal fissure treatment, the relapses number of the disease was reduced by 3.3 times. Conclution. 1. To predict the pathological scarring formation after proctological operations, it is necessary to study the changes dynamics in the concentrations of acute-phase inflammatory proteins in the patients peripheral blood sample. 2. To improve the treatment of patients with a tendency to excessive scarring it is necessary to include anti-scar therapy in the complex of postoperative measures
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