SURGICAL TREATMENT OF CRYPTOGLANDULAR RECTAL FISTULAS

Abstract

Rectal fistulas account for 0.8-1.2% of surgical diseases. There are morphological varieties of rectal fistulas with the presence of branched or horseshoe-shaped passages, which are formed during the spontaneous opening of the abscess. Cryptoglandular rectal fistula is a chronic inflammatory process in the crypt, intersphincter space and pararectal tissue, leading to the formation of a fistula. The affected crypt also serves as an internal fistula foramen. The external opening is most often located on the skin of the perineum, less often in the buttocks, scrotal skin, and vagina. The prevalence of rectal fistulas ranges from 8 to 23 cases per 100,000 population. Most often, the disease develops between the ages of 30 and 50, which determines the social significance of the disease. In men, this pathology is more common than in women. The onset of chronic paraproctitis is usually preceded by acute paraproctitis, spontaneous or surgical opening and drainage of the abscess, without eliminating the entrance gate of infection. Specific examinations include digital examination of the rectum, revision with a button probe, sigmoidoscopy, dye test, ultrasound diagnostics with a rectal probe, fistulography. In case of complex extrasphincter arrangement of the passages, the examination is supplemented by magnetic resonance imaging and examination of the function of the obturator apparatus of the rectum. There are a large number of surgical methods for the treatment of rectal fistulas.