The results of an improved method of surgical treatment of extrasphincter fistulas of the rectum

Aim. To study the effectiveness of using a collagen haemostatic membrane in the surgical treatment of extrasphincteric pararectal fistulae. Materials and Methods. This paper presents the results of the examination and surgical treatment of 100 patients with extrasphincteric pararectal fistulas, and we performed a comparative analysis of three applied methods of surgical treatment of the above-mentioned rectal fistulas: the ligating method, which was performed in 31 patients; a method using the movement of the mucosa according to Maslyak (39 patients), and the proposed method with closing the internal opening using a cologenic hemostatic membrane (30 patients). Results. When using traditional methods of surgical treatment of ESPC, the recurrence rate was 11.4%, and US - 22.9% of cases. When the authors used the method of excision of the fistula using a cologenic haemostatic membrane to close the internal opening, rectal sphincter insufficiency was noted in 13.3% and recurrence in -6.7% of cases. Conclusions. The developed method of using a collagen hemostatic membrane to close the internal opening of the fistula minimises the frequency of disease recurrence. This method of surgical treatment of extrasphincteric rectal fistulas using a collagen hemostatic membrane is a sphincter-sparing procedure, reduces anal sphincter insufficiency and is a promising method of surgical treatment of extrasphincteric pararectal fistulas.