LOOSE SET-ON IN THE TREATMENT OF ACUTE PARAPROCTITIS
Keywords:
inflammation, drainage ligature, fistulas, immediate viscera, LIFT, incontinenceAbstract
Introduction. Severe inflammation is considered the most common pathology in urgent coloproctology. The issue of the development of fistulas of the immediate interior after the tense paraproctitis has been carried out remains unfinished at the present time. Primary radical actions in paraproctitis reduce the frequency of formation of fistulas of the immediate interior, but the presence of this method of healing surprises the muscular fibers of the locking unit of the immediate interior, which can cause anal incontinence. The significance of the draining ligature (loose set-on) in the treatment of fistulas of the immediate interior is widely popular and also well researched, which should not be noted regarding the use of this method in the treatment of strained paraproctitis.
The purpose of the study. To assess the effectiveness of the drainage ligature in the two-stage treatment of patients with paraproctitis. The materials used as well as the methods. To date, Sixty patients with acute ischiorectal paraproctitis have been entered into a retrospective study. Patients existed divided into 2 categories, according to 30 individuals in any. In the initial period of healing, patients of category A were identified and drained of the abscess, patients with category Letter – the identification and drainage of the abscess was supplemented by conducting a drainage ligature through a stunned crypt. In the 2nd period, 22 patients from category A and 30 patients from category B underwent a combined LIFT procedure together with laser destruction of the fistula. Before the other stage of healing, patients of two companies underwent transrectal sound examination (TRUS) together with the target of removing the presence of congestion and cavities. The role of the locking unit of the immediate interior was perceived together with the support of sphincterometry as well as a questionnaire according to the Wexner scale up to and after the 2nd stage of healing.
Results. The usual terms of the study due to patients after the 2nd stage of healing collected
18.3 months in the A team and 16 months in the Letter team. Relapses of the disease in team A were registered at 5 with 22 individuals (22.7%), and in the team of patients together with the performed drainage ligature - at 3 with Thirty individuals (10%). Pathologies of the function of the locking unit after the 1st and 2nd stages of timely healing did not exist in any way registered in any of the companies.
Conclusions. The use of a draining ligature in the two-stage cure of paraproctitis makes it possible to implement decisive supervision over the drainage of the abscess, to develop a combined fistula process in the absence of spurs and also cramps, to organize the patient for another period of surgical cure and also, collectively, to reduce the proportion of relapses after minimally invasive treatment of fistulas of the immediate interior in the absence of loss of function of the anal pulp.
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