METHOD FOR SURGICAL MANAGEMENT OF TRANSSPHINCTER AND EXTRASPHINCTER ANAL FISTULAS

摘要

FIELD: medicine.SUBSTANCE: fistula is separated from an external fistula opening on the perineal skin to reach a rectal wall leaving elements of an anal sphincter intact. A fistulous tract is cut off at the rectal wall with keeping its proximal portion in depth of the anal sphincter, or outside the sphincter. An elastic latex ligature is inserted through an internal fistula opening into the wound with circularly enclosing a mucosubmucous layer and a portion of the internal sphincter. A transected portion of the external sphincter is closed with covering the ligature with muscular tissue of the sphincter. The ligature extends from the internal fistula opening leaving a suture line on the sphincter completely intact.EFFECT: method enables eliminating a rectal fistula with minimising a risk of sphincter suture line disruption, progression of anal sphincter insufficiency and recurrence of the disease by forming an intrasphincter fistulous tract in treating transsphincter and extrasphincter anal fistulas.1 ex