Doktor axborotnomasi 2024, №3 (115)

Тема статьи

OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH TRANSSPHINCTERIC RECTAL FISTULAS (117-121)

Авторы

K. U. Sherkulov1, S. S. Davlatov2, K. E. Rakhmanov1

Учреждение

1Samarkand state medical university, Samarkand, 2Bukhara state medical institute, Bukhara, Uzbekistan

Аннотация

Purpose of the study: to improve the treatment results of patients with transsphincteric fistulas of the rectum by improving the technical aspects of fistulous passage excision. Materials and methods of research. 105 cases were se lected for a prospective dynamic active study, among them patients with transsphincteric fistulas of the rectum. All patients were operated on routinely and, depending on the chosen treatment tactics, were divided into two groups. The first group- Control one, included 56 (53.3%) patients who had their fistulas excised using traditional methods. The second group, the main group, included 49 (46.7%) patients in whom fistula dissection was performed using modified instruments. Results of the study. Patients who underwent LIFT surgery with the use of modified guides and without disruption of the muscle fibers of the anal groin have a significant reduction in the level of pain syndrome in the post operative period and after acts of defecation. This reduction in pain reduces the need for narcotic analgesics and sig nificantly improves the quality of life of patients. Conclusions. The use of sphincter-saving surgical methods in the main group differs from traditional operations on fistula excision with subsequent suture of the sphincter, causing a shorter period of temporary disability - 18.9±3.6 days compared to 32.7±4.6 days; more favorable postoperative course with lower intensity of pain syndrome - 1,6±0,3 on VAS scale in Control with 6,0±0,2 points; shorter hospitali zation - 10,1±2,2 days in Control with 17,4±3,1 days, and more effective postoperative rehabilitation of patients. These factors significantly improve the quality of life after surgery and contribute to lower financial costs to achieve successful treatment outcomes.

Ключевые слова

anal canal, rectum, transsphincter fistulas, surgical treatment.

Литературы

1. Akiba R. T., Rodrigues F. G., da Silva G. Management of complex perineal fistula disease //Clinics in colon and rectal surgery. – 2016. – Т. 29. – №. 02. – P. 092-100. 2. Balciscueta Z. et al. Rectal advancement flap for the treatment of complex cryptoglandular anal fistulas: a system atic review and meta-analysis //International journal of colorectal disease. – 2017. – Т. 32. – P. 599-609. 3. Cadeddu F. et al. Complex anal fistula remains a challenge for colorectal surgeon //International journal of colo rectal disease. – 2015. – Т. 30. –P. 595-603. 4. Davlatov S. S. et al. The choice of surgical treatment tactics in patients with acute paraproctitis //Journal of Hepato-Gastroenterology. – Т. 1. – №. 2. – С. 26-29. 5. Gaertner W. B. et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the man agement of anorectal abscess, fistula-in-ano, and rectovaginal fistula //Diseases of the Colon & Rectum. – 2022. – Т. 65. – №. 8. – С. 964-985. 6. Sherkulov K. U., Radjabov J. P., Usmonkulov M. K. Diagnostics and surgical treatment of rectal fistulas //World Bulletin of Public Health. – 2023. – Т. 19. – С. 28-30. 7. Shekhovtsov S.A., Davlatov S.S. Analysis of Factors Influencing the Results of the Laser Obliteration Technique of Short and Complex Rectal Fistulas// American Journal of Medicine and Medical Sciences 2023, 13(7): 913-916. DOI: 10.5923/j.ajmms.20231307.15