Preoperative Diagnosis of the Functional State of the Sphincter Complex in the Treatment of Rectal Fistulas

Abstract

Abstract. Introduction. Preoperative determination of the functional state of the sphincter apparatus of the rectum is an important part of the treatment of patients. Assessment and analysis of the functional viability of the anal sphincter are necessary for the choice of tactics for surgical correction of rectal fistulas. This approach makes it possible to assess the effectiveness of a specific surgical method and determine the degree of sphincter insufficiency in the postoperative period.
 The aim of the study: to assess the normative values of neurophysiologicsl parameters of the sphincter apparatus of the rectum and pelvic floor muscles by using the method of electrosphincteromyography.
 Materials and methods. The study included 93 patients who were treated in the surgical department of the Kharkiv Regional Hospital for rectal fistulas. Indicators of the contractile function of the sphincter apparatus were determined by the method of interference electrosphincteromyography in the preoperative period. The comparison group consisted of 28 volunteers who did not have rectal diseases associated with impaired intestinal retention function (0 points on the Wexner incontinence scale).
 Results. The standard values of the bioelectrical activity of the sphincter apparatus were obtained by examining a group of volunteers by the method of interference electrosphincteromyography. The analysis of the results obtained demonstrates a slight decrease in the initial indicators of the bioelectric activity of the sphincter complex in the postoperative period.
 Conclusions. Minimally invasive methods of surgical treatment of rectal fistulas are preferred, because during the study, patients showed a decrease in the initial parameters of the contractile viability of the anal sphincter.