STRATEGIES FOR IMPROVING TREATMENT OUTCOMES IN CHRONIC PARAPROCTITIS

Abstract

In the article is presented the evaluation of the influence of the preliminary stage of draining ligature on the processes of remodeling of connective tissue in chronic paraproctitis. The analysis of patients was conducted, to whom excision of pararectal fistula was performed. All patients were divided into 2 groups: main group (with preliminary ligature drainage of the fistulous tract) and comparison group (without drainage). By the method of trichrome staining by Mason it was established the reliable predominance of mature collagen of type I and ordered structure of stroma in the main group. Clinically this was accompanied by reduction of frequency of recurrences and reduction of terms of healing. In the course of the research it was confirmed that preoperative ligature drainage in chronic paraproctitis is a clinically effective method, reliably reducing the frequency of recurrences and improving the indicators of the early postoperative period. The revealed interrelation between favorable morphological changes and improvement of clinical results justifies the application of stepwise ligature treatment in patients with complex forms of chronic paraproctitis.