Comparative analysis of the effectiveness of the treatment of transsphincter anal fistulas by various methods

Author:

Denisenko E. V.1,Denisenko V. L.2,Gain Yu. M.3,Tsyplakov K. G.1,Korobov G. D.4

Affiliation:

1. ME “Vitebsk Regional Clinical Specialized Center”

2. ME “Vitebsk Regional Clinical Specialized Center”; Vitebsk State Medical University

3. Belarusian Academy of Postgraduate Education of Doctors

4. Vitebsk State Medical University

Abstract

AIM: to assess the effectiveness late results of laser technologies in the treatment of anal fistulas compared with traditional methods (excision of the fistula followed by ligature, excision of the fistula followed by restoration of the sphincter).PATIENTS AND METHODS: a single-center retrospective study included 150 patients. Patients underwent 3 variants of surgical intervention. In the first group (50 patients), the fistula was treated with laser technology. In the 2nd group (50 patients), the fistula was excised followed by seton, in the 3rd group (50 patients), the fistula was excised followed by sphincteroplasty. Quality of life (according to the SF-36 school), as well as differences in the proportion of relapses on the 180th day after the surgery was carried out.RESULTS: it was revealed that higher indicators of the components of physical health (PH) (F = 11260.72 p < 0.001), as well as mental health (MN) (F = 10459.6 p < 0.001) were detected in the group of patients treated with laser technology. The calculation of significant differences in the observation groups showed that with the number of observations more than the specified one, it is possible to state a decrease in the number of relapses with the laser treatment method by 2.2 times compared with traditional methods.CONCLUSION: laser technology for anal fistulas is a progressive method that provides a significant reduce of recurrence rate, as well as improving the quality of life of patients in late postoperative period.

Publisher

Russian Association of Coloproctology

Subject

Gastroenterology,Oncology,Surgery

Reference7 articles.

1. Shelygin Yu.A., red. Clinical guidelines. Coloproctology. Moscow, RF: GEOTAR Media. 2015; 528 p. (in Russ.).

2. Pomazkin V.I., Mansurov Yu.V. Treatment of extrasphincteric pararectal fistulas, combined with anal sphincter insufficiency. Aktual question coloproctology. 2007; рр. 91-92. (in Russ.).

3. Shalamov V.I., et al. Experience in the treatment of extrasphincteric rectal fistulas. Bulletin Neo-lodge and Restore Medicine. 2012;13(4):531-532. (in Russ.).

4. Anan M, et al. Fistulotomy with or without marsupialisation of wound edges in treatment of simple anal fistula: a randomised controlled trial. Annals of the Royal College of Surgeons of England. 2019;101(7): 472–478.

5. Alfonso L, Carr S. Fistula InAno. In: StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing. 2021; Bookshelf ID: NBK557517

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