Modern methods of surgical treatment of combined anal and rectal pathology
DOI:
https://doi.org/10.11603/2414-4533.2017.4.8439Keywords:
combined anorectal pathology, anal canal, rectum, modern methods of surgical treatment, stricture.Abstract
The urgency of the problem of combined anorectal pathology is quite high, which have caused today by fast grown number of proctological diseases and absence of single direction for surgical treatment of this category of patients. Besides, there are rather insignificant number of publications with results of scientific researches, which are devoted to studying of this problem. Scar strictures of the anal canal, insufficiency of anal sphincter and also deformations of perianal and pararectal regions and perineum are the most often found among of the complications after combined operations on the anal canal and rectum due to their combined pathology. During the last ten years the “hybrid” operations for treatment of III-IV degrees of chronic haemorrhoids with combination of another anal and rectal pathology are widespread. They include the combination of haemorrhoidal dearterialization with mucopexy or rubber band ligation of haemorrhoids, their lifting and mucopexy with another anal pathology removal. According to progressive development of modern technologies in proctological practice such modern methods of surgical treatment of anorectal pathology as electrothermic system “Liga Sure”, ultrasound harmonic scalpel “Ultra Cision”, laser technologies for treatment of anal fissures, chronic haemorrhoids and fistulas (LHP, FiLaC), plasma scalpel, bipolar system“En Seal”, radiowave scalpel “Surgitron” аnd also methods LIFT (ligation of intersphincteric fistula tract) and VAAFT (Video Assisted Anal Fistula Treatment) have been fast established, which have made less the lasting of operations, volume of bleeding, intensity of the pain syndrome, but, unfortunately, did not exclude such complications as disease recurrences, postoperative bleedings and scar strictures of the anal canal.
So, the urgency of the problem of combined pathology of anal canal and rectum induces to elaboration and establishment new high effective methods of surgical treatment of this pathology in clinical practice, which will provide the absence of complications in postoperative period and the fast medical and social patients rehabilitation.
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