Significance of nontraumatic anal sphincter relaxation for the success of plastic and miniinvasive interventions in coloproctology

Significance of nontraumatic anal sphincter relaxation for the success of plastic and miniinvasive interventions in coloproctology

The investigation objective was to estimate the role of nontraumatic anal sphincter (AS) stretching, as a leading factor of success in minimally invasive and/or plastic proctological interventions. One-centre randomized investigation was performed in 83 patients: In 22 of them the AS fissura was rev...

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Bibliographic Details
Published in:Klinična hìrurgìâ (Kiïv) no. 3; pp. 9 - 11
Main Authors: Podpriatov, S S, Korchak, V P, Ivanenko, S V, Stupak, M I, Zubariev, O V, Ivakha, V V, Sydorenko, O V, Shtaier, A A, Perekhrest, O V, Shchepetov, V V, Rostunov, V K, Bryzhatiuk, S V, Kozlov, V V
Format: Journal Article
Language:Ukrainian
Published: Ukraine 01-03-2013
Subjects:
Anal Canal - drug effects
Anal Canal - physiopathology
Botulinum Toxins, Type A - administration & dosage
Female
Fissure in Ano - pathology
Fissure in Ano - prevention & control
Hemorrhoids - surgery
Humans
Male
Minimally Invasive Surgical Procedures - methods
Muscle Relaxation - drug effects
Rectal Fistula - pathology
Rectal Fistula - prevention & control
Rectocele - pathology
Rectocele - prevention & control
Recurrence
Spasm - physiopathology
Spasm - prevention & control
Surgery, Plastic
Sutures
Treatment Outcome
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Summary:The investigation objective was to estimate the role of nontraumatic anal sphincter (AS) stretching, as a leading factor of success in minimally invasive and/or plastic proctological interventions. One-centre randomized investigation was performed in 83 patients: In 22 of them the AS fissura was revealed (in 16), suprasphincteric fistula (in 3) and coexistent rectocele 2-3 Ap (according to POP-Q classification) with thinning of the AS anterior segment, the degree III hemorrhoids and anterior AS fissure presence. Ninety units of botulotoxin preparation (Disport) were injected between internal and external AS portions 5-15 days preoperatively. The treatment results without botulotoxin injection were compared retrospectively. After botulotoxin injection performance the AS spasm elimination was noted, leading to the pain subsiding promotion before and postoperatively in all the patients observed. The spasm elimination have permitted to escape the anal high fistula recurrence as a result of the mucosal flap shift after intraluminal closure of the fistula or because of the fistula intermuscular electrowelding "suture" rupture, also have guaranteed the plastic sutures on AS, even while the stage II-III rectocele presence, not depending of performance of its simultant surgica correction.
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ISSN:0023-2130