Year 2014 Vol. 22 No 1




SBEE HPE Samara State Medical University,
The Russian Federation

Objectives. To improve treatment results of patients with extrasphincteric pararectal fistulas by means of the operative method of plastic correction.
Methods. The results of the examination and operative treatment of 146 patients with extrasphincteric pararectal fistulas have been analyzed. Clinical and instrumental examination (sigmoidoscopy, test with vital dye, probing of the fistulous passage, sphincterometry, transrectal sonoraphy of the pararectal zone tissues and fistulography) has been performed. Ligature method was applied in 50 (34,2%) patients (the 1st group). Rectoplasty with lateral displacement of the mucous-submucosal rectal flap was performed in 50 (34,2%) cases (the 2nd group). The proposed method of plastic correction was done in 46 (31,5%) patients (the 3rd group). Assessment of the operative treatment results was carried out in the early (up to 3 months) and distant (up to 4 years) postoperative periods.
Results. In the early postoperative period hemorrhage was diagnosed in 2 (4,0%) cases in the 1st group, in 3 (6,0%) in the 2nd group, in 5 (3,4%) in the 3rdst group, in 3 (6,0%) of the 2nd group, in 2 (4,3%) of the 3rdst group, in 6 (12,0%) of the 2nd group, in 3 (8,6%) of the 3rdst group, in 1 (2,0%) of the 2nd group and there wasnt any in the 3rd group.
Conclusions. Minor trauma, the lack of the anal sphincter functional insufficiency, a small number of relapses, reduction of the medical and social rehabilitation terms of patients are considered to be the advantages of the designed method of the operative correction of the extrasphincteric pararectal fistulas.

Keywords: extrasphincteric fistula, mucosa displacement, operative treatment
p. 83 88 of the original issue
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Address for correspondence:
443079, Rossiiskaia Federatsiia, g. Samara, pr. Karla Marksa, d. 165 b, Kliniki Samarskogo gosudarstvennogo meditsinskogo universiteta, kafedra i klinika gospital'noi khirurgii,
Katorkin Sergey Evgenievich
Information about the authors:
Razin A.. A surgeon of coloproctology department, a post-graduate student of the chair of hospital surgery of SBEE HPE "Samara State Medical University."
Zhukov B.N. Honored Worker of Science, MD, professor, a head of the chair of hospital surgery of SBEE HPE "Samara State Medical University."
Chernov A.A. PhD, a head of coloproctology department of hospital surgery of SBEE HPE "Samara State Medical University."
Katorkin S.E. PhD, an assistant professor of the chair of hospital surgery SBEE HPE
"Samara State Medical University".
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