Experience of using the combination of bio-welding and laser ablation in the treatment of anorectal fistulas
DOI:
https://doi.org/10.32782/2415-8127.2023.68.27Keywords:
Anorectal fistula, LIFT, FiLacAbstract
Anorectal fistulas are observed in 15–40% of patients when considering colopectological diseases. Recurrence when performing classic and minimally invasive interventions is from 10% to 40% according to various data. When choosing a method of surgical treatment of anorectal fistulas, preference is given to minimally invasive methods that minimize postoperative complications. The purpose of the study: To evaluate the effectiveness of the suction combination of the modified LIFT technique. Materials and methods: An analysis of the treatment of 34 patients with anorectal fistulas was carried out. Results: The treatment process included 2 stages. The first stage consisted in the elimination of the purulent process, during which the opening and drainage of the abscess was carried out with the help of a seton, for the further formation of a linear fistula. The second stage consisted in disconnected fistulas from the rectum. The combined method of LIFT + laser ablation + biowelding of the fistula was performed. When considering the LIFT method, the main stage of this method is the intersection and sealing of the fistula lumen in the intersphincteric space. Functional insufficiency after surgery was not affected during 4 months. In all cases, the sphincter apparatus was evaluated according to the Wexner scale. There were no complications after the operation. Relapse was noted in 3% of cases. Compared to other LIFT combined methods, this method shows good recurrence rates. Conclusions: 1. The combined LIFT technique significantly reduces the percentage of relapses compared to classical techniques and the standard LIFT technique. 2. In comparison with classical techniques, cases of anal sphincter insufficiency have not been noted when using LIFT and its combination. 3. The choice of seton and patient management during the period of treatment with seton at the first stage of treatment significantly affects the risk of anal incontinence.
References
Outcomes Anestis Charalampopoulos , Dimitrios Papakonstantinou , George Bagias , Konstantinos Nastos , Markos Perdikaris , Savvas Papagrigoriadis. Surgery of Simple and Complex Anal Fistulae in Adults: A Review of the Literature for Optimal Surgical. DOI: 10.7759/cureus.35888; ст. 2–3.
Alexander Herold,Paul-Antoine LehurKlaus E. Matzel,P. Ronan O'Connell. Coloproctology second edition. 2017р. ; ст. 59–73.
O. E. Kanikovskyi, A. V. Osadchyi, O. A. Kotsyura, A. V. Tomashevskyi, T. P. Zarezenko. SPHINCTEROPLASTY FOR ANAL INCONTINENCE ON THE BASIS OF NECROTIC FASCIITIS OF THE PERINEUM. DOI: https://doi.org/10.31612/2616-4868.3(9).2019.06 c. 48
Kamal Gupta, Kushal Mital and Ruby Gupta. DISTAL LASER PROXIMAL SLOFT (DLPS) – A NEW APPROACHFOR MANAGEMENT OF FISTULA IN ANO.
L Dekker, D D E Zimmerman, R M Smeenk, R Schouten, I J M Han-Geurts. Management of cryptoglandular fistula-in-ano among gastrointestinal surgeons in the Netherlands. DOI: 10.1007/s10151-021-02446-3. с. 2.
Siripong Sirikurnpiboon. The risk factors for failure and recurrence of LIFT procedure for fistula in ano. DOI: 10.47717/turkjsurg.2023.5807. c. 2–3.
Omar Vergara-Fernandez, Luis Alberto Espino-Urbina. Ligation of intersphincteric fistula tract: what is the evidence in a review? DOI: 10.3748/wjg.v19.i40.6805
Baocheng Zhao, Zhenjun Wang, Jiagang Han, Yi Zheng, Jinjie Cui , Sanshui Yu. Long-Term Outcomes of Ligation of the Inter-Sphincteric Fistula Tract Plus Bioprosthetic Anal Fistula Plug (LIFT-Plug) in the Treatment of Trans-Sphincteric Perianal Fistula. 2 c.
Qiuxiang Yu, Congcong Zhi, Lansi Jia, Hui Li. Cutting seton versus decompression and drainage seton in the treatment of high complex anal fistula: a randomized controlled trial. DOI: 10.1038/s41598-022-11712-9
Salah M Raslan, Mohammed Aladwani, Nasser Alsanea. Evaluation of the cutting seton as a method of treatment for perianal fistula.
