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TO THE PROBLEM OF SURGICAL TREATMENT FISTULA ANUS AND RECTUM

https://doi.org/10.33878/2073-7556-2017-0-3-28-33

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.

About the Authors

L. I. Vasilenko
Donetsk National medical university named after M.Gorky
Russian Federation


V. I. Shalamov
Donetsk National medical university named after M.Gorky
Russian Federation


G. E. Polunin
Donetsk National medical university named after M.Gorky
Russian Federation


V. A. Gulmamedov
Donetsk National medical university named after M.Gorky
Russian Federation


V. I. Volkov
Donetsk National medical university named after M.Gorky
Russian Federation


V. A. Likov
Donetsk National medical university named after M.Gorky
Russian Federation


I. A. Tanasov
Donetsk National medical university named after M.Gorky
Russian Federation


Y. A. Gerasimenko
Donetsk National medical university named after M.Gorky
Russian Federation


O. N. Fedorchuk
Донецкий национальный медицинский университет им. М.Горького
Russian Federation


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Review

For citations:


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. TO THE PROBLEM OF SURGICAL TREATMENT FISTULA ANUS AND RECTUM. Koloproktologia. 2017;(3):28-33. (In Russ.) https://doi.org/10.33878/2073-7556-2017-0-3-28-33

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ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)