Биология ва тиббиёт муаммолари 2024 №4 (155)
Maqola mavzusi
OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH EXTRASPHINCTER FISTULAS OF THE RECTUM (277-279)
Mualliflar
Sherkulov Kodir Usmonkulovich, Davlatov Salim Sulaymonovich, Rakhmanov Kosim Erdanovich
Muassasa
1 - Samarkand State Medical University, Republic of Uzbekistan, Samarkand; 2 - Bukhara State Medical Institute, Republic of Uzbekistan, Bukhara
Annotatsiya
The relevance of research. Today, if we talk not about any single universal method, but about the development of a certain direction, approach to the treatment of rectal fistulas, there are significant positive changes. Thus, starting from the end of the last century, against the backdrop of the development of medical technologies, methods for the treatment of rectal fistulas began to appear and are actively developed, in which the sphincter apparatus is not directly affected. Purpose of the study is to improve the results of treatment of patients with extrasphincteric fistulas of the rectum by improving the technical aspects of excision of the fistulous passage. Materials and methods of research. Eighty-five cases were selected for a prospective dynamic active study. Among them were patients with extrasphincteric 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, the Control group, included 56 (65.9%) patients who had their fistulas excised using traditional methods. The second group, the main group, included 29 (34.1%) patients in whom fistula dissection was performed using modified instruments. Conclusions. The developed innovations in the technical aspects of surgical treatment of patients with rectal fistulas led to an improvement in the standards of medical care, reducing the incidence of immediate postoperative complications from 8.9% to 3.4%. The use of a modified button probe and flexible cylindrical conductor with olive in the surgical treatment of complex rectal fistulae not only simplifies the process of technical implementation, but also prevents damage to the muscle fibers of the anal ileum. In addition, this method requires less operative time, 44.2±5.1 minutes compared to 80.5±7.3 minutes.
Kalit so'zlar
anal canal, rectum, extrasphincteric fistulas, treatment.
Adabiyotlar
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 sys-tematic 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 chal-lenge 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 management 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 Tech-nique 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