METHOD FOR ANAL STRICTURE SURGICAL MANAGEMENT Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to surgery and coloproctology. After hydraulic preparation of pararectal tissues by introduction of 60–80 ml of normal saline in the area of stricture, cicatrical tissue is excised, forming a stricture to an internal sphincter down to 1 cm and to a healthy anoderm on the sides, in a proximal direction to an anorectal fold. Further, from the buccal mucosa, at 1.5 cm from the marked excretory duct of the parotid salivary gland. Full-thickness flap is taken with the area of the corresponding area of the defect formed as a result of stricture excision, and hemostasis is performed. Mucosal wound edges are closed with Vicryl 3.0–4.0, submucosal elements are removed, and the graft is irrigated with isotonic solution. Fixing to edges of wound defect in anal canal with single sutures first from above, then from below and further along lateral edges without tension with Vicryl 4.0 on atraumatic round needle, distance between sutures 2–3 mm. Nodes are located outside, in the lumen of the anorectal zone; the graft is fixed to the wound bottom with single staggered sutures. Operation is completed by inserting a gas outlet tube wrapped in a single layer of a haemostatic sponge into the anal canal.

EFFECT: method allows replacing significant wound surfaces formed after excision of cicatrical stricture of anus or stricturotomy with low traumatism, thus recreating elasticity of anal canal walls.

2 cl, 2 dwg, 1 ex