METHOD OF TREATING CHRONIC PARAPROCTITIS COMPLICATED BY FORMATION OF TRANSSPHINCTERIC OR EXTRASPHINCTER ANAL FISTULA Russian patent published in 2019 - IPC A61B17/00 A61M27/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to coloproctology. At the first stage of treatment, a continuous long-term drainage of the fistulous canal is performed by means of permanent latex drain ligature. Drainage installation and degree of "tightening" ligature are determined based on sphincterometry, namely: with sphincterometry higher than 100.8 ± 11.4 mm Hg. at rest and 137.1 ± 12.6 mm Hg. with voluntary reduction, drainage is installed with "cutting" function; thereafter, 4–6 weeks later, with repeated sphincterometry, if the values become less or equal to the above data, the drainage is installed with a "draining" function. At the second stage of treatment 50–90 days later, after the pyoinflammatory process signs are recovered and the sphincterometry numbers are normalized, a radical surgical intervention is performed, during which the probe is inserted into the fistula in parallel to the previously installed drain ligature "Seton". End of the probe is brought out through an internal hole of the fistula in the rectal lumen. Then, all tissues separating the fistula from the anus canal are dissected by a radio-wave apparatus in a "cutting" mode of 30 watts and "coagulation" of 40 watts. Wound is left open on length of 1–2 cm near the external hole with excision of the adjacent skin area.

EFFECT: method enables reducing the pain syndrome in the preoperative and postoperative periods, reducing the wound healing time by adequate drainage of the purulent cavity and create favourable conditions for recovered excised fistulous passage, reduce postoperative recurrence rate, and reduce number of postoperative complications.

1 cl, 1 ex