The only method of treatment of chronic paraproctitis - is surgical. By the operation may be contraindicated, such as serious illness of various organs and systems in the stage of decompensation. But still, it must be remembered that the fistula can be cured only by surgery.
At present, it is recommended not to delay the operation "on the back burner." In the case of acuteparaproctitis, initially held its treatment and elimination of purulent inflammation. Only then should proceed to surgery for excision adrectal fistula.
So, to postpone surgery for a fistula is not considered appropriate, since the aggravation of the process can be repeated again, as long it leads to scarring within the walls of the anal canal and anal canal deformation adrectal fiber and the development of anal sphincter insufficiency.
In the absence of purulent process, only when there is infiltration along the fistula, conducted anti-inflammatory therapy: antibiotics, physiotherapy, and then performed the operation. In the absence of an acute process operation is carried out routinely.
In the case of stable remission, when the fistulous openings are closed, it is advisable to postpone the operation, as in this case the doctor would be difficult to clearly identify the fistula and the surrounding tissue to provide a radical intervention.
Methods of surgical treatment of fistula adrectal
Among the types of transactions, which are used in the treatment of adrectal fistula is isolated:
Dissection adrectal fistula into the lumen of the rectum.
Excision adrectal fistula into the lumen of the rectum.
Excision adrectal fistula into the lumen of the rectum with simultaneous opening and drainage of purulent streaks.
Excision adrectal fistula into the lumen of the rectum, followed by suturing of the anal sphincter.
Excision of fistula adrectal holding ligatures.
Excision of the fistula with the movement adrectal muco-muscular flap of the distal rectum in order to eliminate the internal opening of fistula.
The choice of an operation for fistula adrectal influenced by various factors:
Progress with respect to the location of the fistula external anal sphincter.
The degree of severity of cicatricial process in the wall of the rectum, the internal fistula opening and in the course of the fistula.
The presence of purulent cavities and inflammatory infiltrates in paraproctium.
Operations on the adrectal fistula are usually carried out under general anesthesia.