METHOD FOR SURGICAL MANAGEMENT OF PARARECTAL FISTULAS Russian patent published in 2024 - IPC A61B17/00 A61B17/115 A61M25/01 A61L24/00 

FIELD: medicine; surgery; proctology.

SUBSTANCE: at the first stage of treatment, which lasts 14 days from the beginning of the acute process, all purulent cavities in pararectal fat are sanitated and drained. At the second stage of treatment, radical closure of the internal opening of the fistulous passage is performed through the anoscope by circular resection of the rectal mucosa and submucosal layer in the proximal direction of the dentate zone. Resection plane should be located in an oblique-horizontal direction at angle of 30° to the length of rectum. Most distal point of the anastomosis is located in the area of the probable location of the internal opening of the fistula; most proximal part of anastomosis is located in diametrically opposite direction. Through a PVC catheter inserted into the fistula, a tissue medical glue "Sulphacrylate" in amount of 0.2–0.3 ml is introduced into the closed blind end of the fistula, and the sutured internal opening of the fistula is reinforced from the inside, while the distal portion of the fistula is left open until healing.

EFFECT: method provides a reduction in the length of treatment, a good functional result of the operation, is a low-traumatic, effective method of treatment, enables to reduce postoperative complications, including strictures of anastomosis, stenosis of anus, due to hardware resection of mucous-submucosal layer in oblique-horizontal direction and intra-fistula filling of proximal part of fistula.

1 cl, 1 dwg, 2 ex