Novosti
Khirurgii

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Year 2018 Vol. 26 No 5

REVIEWS

V.V. HOMOCHKIN, S.S. MASKIN, N.V. HOMOCHKINA, V.V. EROFITSKAYA

LIGATION OF THE INTERSPHINCTERIC FISTULA TRACT IN TREATMENT OF CHRONIC PARAPROCTITIS

Volgograd State Medical University, Volgograd,
The Russian Federation

In the review, a comparative analysis of the use of traditional techniques and organ-preserving ligation of intersphincteric fistula tract (LIFT) in the treatment of chronic paraproctitis was carried out. The use of traditional methods is effective in 60-80% of cases; nevertheless, the risk of anal incontinence formation is, on average, 28%. The ligation of the intersphincteric fistula tract (LIFT) allows achieving convalescence in 82 - 95% of cases, and besides the majority of specialists emphasizes almost complete absence of disturbance of anal competence. In the vast majority of cases, recurrence of the postoperative fistula is formed as intersphincteric type that allows eliminating it without any risk of incontinence. In rare cases of «complete» recurrent fistula formation there is a possibility to perform sphincter-preserving operation. In patients with initially recurrent fistulas, the percentage of recovery is 90% and more. While comparing the classical operation LIFT and LIFT-plus (with the removal of distal part of fistula), the efficiency of LIFT- plus is higher by an average of 4-5%.
The performed analysis proves the advantages of the sphincter-saving operation LIFT in comparison with the classical methods of elimination of the pararectal fistulas. The problem of combining the LIFT with other procedures remains unsolved and demands further investigations.

Keywords: pararectal fistula, fistula excision, sphincter-saving techniques, incontinence, ligation of the intersphincteric fistula tract
p. 616-623 of the original issue
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Address for correspondence:
400131, Russian Federation,
Volgograd, Pavshikh Bortsov Sq., 1,
Volgograd State Medical University,
Depatrment of Surgical Diseases
And Neurosurgery,
Tel.: +7 988 490 75 00,
e-mail: homochkinS@rambler.ru,
Vitaliy V. Homochkin
Information about the authors:
Homochkin Vitaliy V., PhD, Associate Professor of the Department of Surgical Diseases and Neurosurgery of the Faculty of Advanced Training of Physicians, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0003-0144-8264
Maskin Sergey S., MD, Professor, Head of the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-5275-4213
Homochkina Nataliya V., Clinical Intern of the Department of Surgical Diseases and Neurosurgery of the Faculty of Advanced Training of Physicians, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-8480-6639
Erofitskaya Victoria V., Assistant of the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0001-5767-6034
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