SELECTION OF METHOD OF INTERSPHINCTER LIGATION AND EXCISION OF A FISTULA WITH ANAL SUTURE WHEN TREATING RECTAL FISTULAS
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Abstract
Chronic paraproctitis (pararectal fistula, rectal fistula) is one of the most common diseases in coloproctology, occupying 25-30% of the structure of colorectal pathology. According to literature data, the incidence of the disease can reach 23 cases per 100,000 population, and is more common in young and middle-aged people, which determines the social significance of the pathology. As a rule, pararectal fistulas are a consequence of previously suffered acute paraproctitis, the proportion of the latter reaches 0.5 - 4.0% in the structure of the entire general surgical pathology. Against the background of the diversity of anatomical localization of the inflammatory process, simple opening of the abscess and drainage of the purulent cavity often leads to repeated relapses of the disease, occurring in 4.0 -10.0% of cases. The transition of an acute process to a chronic one can be avoided by identifying and eliminating the internal opening of the abscess, which connects its cavity with the intestinal lumen and determines the formation of a perirectal fistula. In this regard, a differentiated approach to the treatment of acute paraproctitis is necessary.
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