CAPABILITIES OF LASER AND NEW TECHNOLOGY IN THE COMPLEX TREATMENT OF PATIENTS WITH RECTAL POSTTRAUMATIC FISTULAS

V.A.DERBENEV, M.M. MAMEDOV, KH.N. MUSAYEV, N.I. MAMEDOV, KH.T.ABBASOVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

State Research Center of Laser Medicine of FMBA, RUSSIA

Objective of investigation. To improve the results of surgical treatment of post-traumatic rectal fistulas of various degrees of severity, by fistulectomy with the use of modern laser technology and new technologies.

Materials and methods. 134 patients with post-traumatic rectal fistulas of different etiologies at the age from 8 to 83 were divided into two groups. The control group included 58 (43.3%) patients (35 men (60.3%), 23 women (39.7%) with post-traumatic rectal fistulas, where the treatment was carried out by the traditional method. In the main group, consisting of 76 (56.7%) patients with post-traumatic rectal fistulas (46 men (60.5%), 30 women (39.5%), surgical interventions were performed with the use of modern laser technology with special tools and new technologies. In the main group one-stage surgical treatment was carried out in -30 (39.5%), and multistage surgical treatment in 46 (60.5%) patients. During the surgical operation, we used the carbon dioxide laser device “Lancet, 2” (Russia), with the wave length of 10.6 mcm, and up to 20 watts power, and a contact laser "Atkus-15" (Russia), which generates a wavelength of 0.81 mcm, and up to 15W of power. In the postoperative period all the patients of the study group underwent irrigation of the wound channel in the paraproctium by antiseptics and percutaneous and transdrainage laser illumination by the “NEEDLE” (Russia), with wavelength of 0.89 mcm and 20 mW of output power with 10-12 minute exposure within 10 -12 days. The illumination was carried out for postoperative decongestion, relieving of pain and improving the properties of the reparative tissues.

Thus, the use of high-and low-intensity lasers may reduce the terms of necrolysis, speed up formation of granulation and epithelialization of purulent wounds in patients with post-traumatic anorectal fistulas and reduce the period of rehabilitation.

Date: 2014-12-28; view: 773