A. S. Aleksandrov

Objective. To study the immediate and remote results of treatment in patients with rectal fistulas, in whom Gabriel operation, Maslyak operation, and the ligature method were applied, as well as to create optimal indications to every kind of surgical intervention. Materials and methods. Results of treatment of 50 patients, suffering rectal fistulas, were analyzed. In 6 (12.0%) patients with intersphincteric and in 26 (52.0%) with transsphincteric fistulas Gabriel operation was performed, in 9 (18.0%) patients with transsphincteric and in 5 (10.0%) with extrasphincteric fistulas – Maslyak operation. In 2 (4.0%) patients with transsphincteric and in 2(4.0%) with extrasphincteric fistulas the ligature method was applied. Results. In 6 mo after Gabriel operation the anal sphincter insufficiency was noted in 2 (6.2%) patients with transsphincteric fistulas. Fistula’s recurrence have had occurred in 1 (7.1%) patient after Maslyak operation. Good remote results were obtained in all patients, operated with application of the ligature method. Conclusion. There was established, that Gabriel operation results are the best for intrasphincteric fistulas. In transsphincteric fistulas application of this operation must be restricted. Maslyak operation and the ligature method are rather effective in transsphincteric and extrasphincteric fistulas – 92.9 and 100.0% good results accordingly.

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy. Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure. Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group. Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.