Сборник предназначен студентам, интернам, резидентам, магистрантам
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- Conclusions
| The purpose of the study:
To improve the results of surgical treatment of patients with epithelial coccygeal passage by developing and implementing an effective surgical method, including measures to prevent recurrence of the disease. Materials and methods : The results of surgical treatment of 41 patients with epithelial coccygeal fistula (further ECF), were treated at the clinic of the University Hospital of the Non-Commercial Joint-Stock Company "Semey Medical University" (further UH NCJSC "SMU") for the period from 2019 to 2022 were analyzed. The ratio of men was 34 (82,9%), women - 7 (17,1%). The age of the patients varied from 19 to 51 years. The average age of patients is 37,2 ± 1,2 years. Among them, 14 (34,1%) patients with relapses of the disease after previous surgical treatment (6 patients with multiple relapses).In the study group: in 10 (24,4%) patients with severe inflammation in the ECF, open wound conduct was applied; in 11 (26,8) patients with uncomplicated flow of the pathological process, excision of the ECF was performed with suturing of the wound longitudinally tightly by Donati sutures; in 20 (48,8%) patients with multiple fistula passages and a widespread lesion, radical excision of the ECF with sacrococcygeal region plastic surgery with displaced non-free skin flaps in the developed in the UH NCJSC "SMU". The choice of the method of surgery depended on the prevalence of the inflammatory process, the duration of the disease, the presence of a history of relapses. 197 Results: The analysis of the results showed the possibility of improving the effectiveness of the treatment of ECF through an individual approach to determining the indications and choosing the method of surgery. In the group with plastic surgery of the sacrococcygeal region with displaced non-free skin flaps, postoperative complications and relapses were not observed in the developed clinic of the UH NCJSC "SMU". In the group of patients with open wound management, 3 relapses were registered, which came through 2-5 months after surgery through pronounced infiltrative-inflammatory reactions and scarring changes during wound healing by secondary tension. When performing radical operations with suturing the edges of the wound to the bottom (at the sutures Donati), 2 recurrences were revealed due to pronounced tension of the edges of the wound, their eruption at the bottom of the wound and the formation of residual cavities in the early postoperative period. The terms of inpatient treatment in these three groups ranged from 8 to 13 days, on average, 9,5 ±2,3 bed days. Conclusions: The technique of surgery for ECF should be justified individually, depending on the severity and prevalence of the inflammatory process. The most promising in terms of improving the long-term results of treatment of ECF (including recurrent fistulas) are radical operations with the possibility of simultaneous closure of the surgical wound with non-free skin flaps. жүктеу/скачать 4,77 Mb. Достарыңызбен бөлісу:
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