The choice of method and results of surgical treatment for rectal fistulas

Abstract

Objective. To study the immediate and remote results of treatment in patients with rectal fistulas, in whom Gabriel operation, Maslyak operation, and the ligature method were applied, as well as to create optimal indications to every kind of surgical intervention. Materials and methods. Results of treatment of 50 patients, suffering rectal fistulas, were analyzed. In 6 (12.0%) patients with intersphincteric and in 26 (52.0%) with transsphincteric fistulas Gabriel operation was performed, in 9 (18.0%) patients with transsphincteric and in 5 (10.0%) with extrasphincteric fistulas – Maslyak operation. In 2 (4.0%) patients with transsphincteric and in 2(4.0%) with extrasphincteric fistulas the ligature method was applied. Results. In 6 mo after Gabriel operation the anal sphincter insufficiency was noted in 2 (6.2%) patients with transsphincteric fistulas. Fistula’s recurrence have had occurred in 1 (7.1%) patient after Maslyak operation. Good remote results were obtained in all patients, operated with application of the ligature method. Conclusion. There was established, that Gabriel operation results are the best for intrasphincteric fistulas. In transsphincteric fistulas application of this operation must be restricted. Maslyak operation and the ligature method are rather effective in transsphincteric and extrasphincteric fistulas – 92.9 and 100.0% good results accordingly.

Keywords

• rectal fistula
• іntrasphincteric fistula
• transsphincteric fistula
• extrasphincteric fistula
• anal incontinentia
• the ligature method
• the laser ablation