Combined use of techniques of fistula ligation in the intersphincteric space and laser destruction of the fistula tract in patients with chronic paraproctitis

Abstract

The OBJECTIVE was to improve the treatment outcomes of patients with chronic paraproctitis using the combination of minimally invasive techniques.METHODS AND MATERIALS. The treatment outcomes of 170 patients with transsphincteric anal fistulas of cryptoglandular origin were analyzed. The duration of the disease in both groups varied within 2–34 months. The main group included 85 patients operated with a combined minimally invasive method (laser destruction of the fistulous tract with subsequent ligation and its ligation in the intersphincter space), in the control group, 85 patients underwent LIFT procedure.RESULTS. Median follow-up for patients in the main group was 13 months, in the control group – 24 months. In the main group, relapses were registered in 10 patients (11.8 %), in the control group – in 22 patients (25.9 %). The average time for the formation of relapses in the main and control groups was 4 months. There was no clinically significant violation of the function of the rectal obturator in both groups.CONCLUSION. The ability to combine the LIFT procedure and laser destruction of the fistulous tract allows to achieve fewer relapses compared to the isolated use of the LIFT technique in patients with transsphincteric anal fistulas.

Keywords

• anal fistula
• chronic paraproctitis
• lift
• filac
• minimally invasive treatment of anal fistula
• anal fistula relapses