Combined technique of ultrasound diagnosis in chronic paraproctitis and substantiation of the extent of surgical intervention
Background. The purpose of the study is to evaluate possibilities of the combined method of ultrasound examination in patients with chronic paraproctitis and to substantiate the extent of surgical intervention. Materials and methods. 114 patients of both sexes (66 men, 48 women) aged 25 to 59 years participated in the study and were diagnosed on the basis of the survey for chronic paraproctitis. Comprehensive survey was conducted using the traditionally accepted methods. Additionally, a combined ultrasound examination was performed. This technique was applied within one day before surgery using of an ultrasound scanner SLE-101PC by a double (abdominal and transrectal) technique with 3.5 MHz sensors 5–7.5 MHz, respectively. Results. Our preoperative ultrasound examination in all patients with chronic paraproctitis has allowed to objectively confirm its high informativeness regarding the identification of the internal openings of the fistulas and their branches. 110 patients (96.49 %) were objectively diagnosed to have an internal opening of the fistula. In this case, additional branching of the fistula was determined in 95 patients (83.3 %). Conclusions. 1. At the preoperative stage, a combined ultrasound study should be used in patients with chronic paraproctitis to provide a clear determination of the localization of the inflammatory focus, to trace the fistulous tract, and to detect its internal opening in patients with chronic paraproctitis. 2. In patients with complex pararectal fistulas, in case of combination with the infiltrative-inflammatory process in pararectal tissue, it is advisable to use the contrast technique of ultrasound examination. The combined ultrasound and contrast technique allowed to reveal the internal fistula opening in 96.7 % of patients, branching and infiltrative-inflammatory changes in pararectal tissue — in 83.3 %, which allowed to determine the adequate extent of surgical intervention.
Full Text:PDF (Українська)
Шелыгин Ю.А. и соавт. Клинические рекомендации. Колопроктология / Под ред. Ю.А. Шелыгина. — М.: ГЭОТАР-Медиа, 2015. — 528 с.
Колоректальная хирургия: Учеб. пособие / Под ред. С.К.Р. Филлипса, Г.И. Воробьева. — М.: ГЭОТАР-Медиа, 2009. — 352 с.
Магнитно-резонансная томография: Рук-во для врачей / Под ред. Г.Е. Труфанов, В.А. Фокин. — СПб.: Фолиант, 2007. — 688 с.
Ультразвуковая диагностика в хирургии. Основные сведения и клиническое применение: пер. с англ. под ред. С.А. Панфилова. — М.: Бином, 2007. — 600 с.
Visscher A.P. Long-term follow-up after surgery for simple and complex cryptoglandular fistulas: fecal incontinence and impact on quality of life / A.P. Visscher, D. Schuur, R. Roos, G.J. van der Mijnsbrugge, W.J. Meijerink, R.J. Felt-Bersma // Dis. Colon. Rectum. — 2015. — № 58(5). — Р. 533-539.
Aboulian A. Early result of ligation of the intersphincteric fistula tract for fistula-in-ano / A. Aboulian, A.H. Kaji, R.R. Kumar // Dis. Colon. Rectum. — 2011. — № 54. — Р. 289-292.
Alasari S. Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract (LIFT) / S. Alasari, N.K. Kim // Tech. Coloproctol. — 2014. — № 18(1). — Р. 13-22.
Wałęga P. VAAFT: a new minimally invasive method in the diagnostics and treatment of anal fistulas-initial results / Р. Wałęga, М. Romaniszyn, W. Nowak // Pol. Przegl. Chir. — 2014. — № 86(1). — Р. 7-10.
Garcés-Albir M.I. Quantifying the extent of fistulotomy. How much sphincter can we safely divide? A three-dimensional endosonographic study / M.I. Garcés-Albir, S.A. García-Botello, P. Esclapez-Valero, A. Sanahuja-Santafé, J. Raga-Vázquez, A. Espi-Macías, J. Ortega-Serrano // Int. J. Colorectal. Dis. — 2012. — № 27(8). — Р. 1109-1116.
- There are currently no refbacks.
Copyright (c) 2018 Health of Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018