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Khirurgii

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Year 2018 Vol. 26 No 5

GENERAL & SPECIAL SURGERY

S.V. SHAKHRAY, Y.M. GAIN, M.Y. GAIN, D.V. KUDRYTSKI

EFFICIENCY ASSESSMENT OF COMPLEX TREATMENT OF ANAL CONDYLOMATOSIS

Belarusian Medical Academy of Post-Graduate Education, Minsk,
The Republic of Belarus

Objective. To evaluate the clinical efficacy of the combined method of anal condylomatosis treatment, based on laser tumor destruction and immunomodulatory therapy.
Methods. The study included 2 stages. At the first retrospective stage the analysis of 60 patients with anal condylomatosis treatment using laser and electrosurgical destruction methods was performed, immune therapy was not used. The duration of the wound epithelialization, recurrence rate were studied. In the second, prospect study 60 patients were observed; the physical methods of condyloma destruction were supplemented with the therapy of human recombinant interferon α2b and imiquimod.
Results. According to the data obtained during the study, laser and electrosurgical destruction are effective methods of anal condylomatosis treatment. Laser destruction has certain advantages: higher epithelialization rate in the area of exposure (ANOVA, p=0.00001) and fewer recurrences of the disease in terms of 2 years’ follow-up (Pearson’s chi-squared test, χ2 = 4.89; p=0.0270). The separate use of physical methods in the treatment of this pathology leads to a much greater number of relapses compared with the complex approach, where laser and electrocoagulation destruction is supplemented with immune and antiviral treatment by human recombinant interferon α2b and imiquimod (Cochran’s Q test, Q=9.591549, p = 0.022378). Also the time interval without the disease progressing was longer in this groups (Kaplan-Meier test, p=0.01528).
Conclusions. The results of the study allow us to state that the use of laser radiation for the destruction of anal condylomas has several advantages over electrocoagulation: a lower risk of recurrence, a shorter period of epithelialization of the wound. The use of immunomodulatory therapy with human recombinant interferon α2b and topical application of imiquimod significantly reduces the frequency of the disease recurrence.

Keywords: condylomatosis, anogenital warts, laser, electrosurgical destruction, interferons, imiquimod
p. 563-569 of the original issue
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Address for correspondence:
220013, The Republic of Belarus,
Minsk, P. Brovki Str., 3-3,
Belarusian Medical Academy of Post-Graduate Education,
Department of Urgent Surgery,
Tel.: +375 17 225 88 10,
e-mail: mishahain@tut.by,
Yuri M. Gain
Information about the authors:
Shakhrai Siarhei V., MD, Professor of the Department of Urgent Surgery, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-9423-9535
Gain Yuri M., MD, Professor, Vice-Rector for Scientific Work, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-7622-5642
Gain Mikhail Yu., PhD, Associate Professor of the Department of Urgent Surgery, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-9012-5277
Kudrytski Dzmitry V., Post-Graduate Student of the Department of Urgent Surgery, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-8581-2494
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