Treatment of rectal fistulas with application of unreconstructed collagen
Abstract
Aim of investigation. To improve results of treatment of extrasphincter and transsphincteric fistulas of rectum.
Material and methods. Treatment experience of 70 patients aged 22 to 61 years with extrasphincteric and transsphincteric rectal fistulas using new surgical technique: resection of fistulous tract, internal ostium plastic by allocollagen membrane and sealing of excised fistulous tract by bioplastic material is presented.
Results. In remote postoperative period, in 5 months to 3 years, 45 (64,3 %) patients were followed-up. In 4 (5,7%) patients relapse of disease was detected: in 3 (4,3%) cases fistula relapse in its initial location, these patients underwent segmentary proctoplasty, the fistula was closed, in one case (1,4%) after 2 months postsurgery intrasphincteric fistula was found that required resection into intestinal lumen. Good functional results were confirmed by sphincterometry and profilometry both in preoperative period, and in 3 months after surgery in 15 (21,4%) patients. No decrease of obturative rectum device scores was revealed.
Conclusion. Application of bioplastic material can be technique of choice at treatment of extrasphincter and transsphincteric fistulas with involevement of deep portion of sphincter.
About the Authors
S. A. Frolov
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
A. M. Kuzminov
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
Sh. T. Minbayev
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
V. Yu. Korolik
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
L. P. Orlova
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
O. Yu. Fomenko
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
N. A. Polyakova
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
I. S. Bogormistrov
Federal state-funded institution «State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
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Review
For citations:
Frolov S.A., Kuzminov A.M., Minbayev Sh.T., Korolik V.Yu., Orlova L.P., Fomenko O.Yu., Polyakova N.A., Bogormistrov I.S. Treatment of rectal fistulas with application of unreconstructed collagen. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2014;24(6):65-72. (In Russ.)
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