Background and Aim of Study: Rectal fistulae make 20% of all proctologic pathology. Despite numerous methods of surgical treatment of rectal fistulae, percentage of recurrence does not tend to decrease. Complicacy of surgical correction consists in balance between radical surgery with total resection of fistulae and minimal damage of anal sphincter. Development and implementation of novel mini-invasive methods of surgical treatment remains actual in surgery. The aim of the study: to compare and analyze results of treatment of transsphincter rectal fistulae using standard methods and using biowelding. Materials and Methods: We carried out retro-and prospective research of surgical treatment of 57 patients with transsphincter rectal fistulae. All patients were treated in surgical development during September 2018 to November 2019. All patients were divided into two groups. First group included 30 patients, treated with standard methods (resection of fistula with sphincterectomy and incision of rectal fistula with sphincteroplasty). Other group included 27 patients, who were treated with biowelding. Results: According to data, satisfactory result of treatment in first group was observed in 66.7% of cases; in second group success was in 96.3%. Usage of biowelding for removal of intrasphincter part of fistula allowed both decreasing of surgery duration and preventing damage of sphincter apparatus. Conclusions: Excision of rectal fistulae using biowelding can be effective for treatment of such patients. Usage of this method allowed avoiding damage of sphincter apparatus, shortening time of wound healing and number of hospital stay, decreasing expression of pain syndrome in postoperative period.
Gamma activation method on linac NSC KIPT, IR-spectrometry and crystal-optical investigations have been used to determinate the content of elements, the phase analysis and structural features of a different organic and inorganic compound in gallstones of patients with hiatal hernia in Kharkiv region. It is shown that it is possible to establish the presence in gallstones of such compounds as bilirubin and its salts, calcium phosphates, calcium carbonate, and different microelements. In the main, the patients of the Kharkiv region have gallstones of mixed type with a combination of cholesterol, calcium carbonate bilirubinate.
Abstract. Aim. Modern surgical approaches to the treatment of anal fistulas involve operations that least damage the sphincter complex of the rectum. The essence of the operation is a complete excision of the anal fistula, which is often accompanied by a significant number of recurrences depending on the chosen method of operation. Failure is likely the result of inflammation that persists after surgery, and cytokines play an important role in these processes. The aim of the study: evaluate local production and determine the role of IL-6 and TNFα in the formation of rectal fistulas. Materials and methods. The tissue of the fistula tract was obtained in 90 patients of both sexes with transsphincteric fistula of cryptoglandular origin in the period from September 2018 to February 2020, who underwent surgery (fistulotomy, modified technique LIFT, use of biowelding technique of the fistula tract). Results. The frequency of IL-6 producing cells was highest (32.0±4,0) specimens in the field of view not only in inflammatory infiltrate, but also in granulation tissue and immature connective tissue of the fistula tract. The lowest rates of IL-6 producing cells were (23.0±3,0) specimens in the field of view. The frequency of TNFα receptor-producing cells ranged from (17.0±1,0) specimens in the field of view to (24.0±3,0) specimens in the field of view. Conclusions. A large number of IL-6 and TNFα-producing cells has been identified not only in inflammatory infiltration but also in granulation and immatureconnective tissue, indicating the active role of these cytokines in the formation of rectal fistulas.
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