EXPERIENCE OF USING DRAINING AND CUTTING SETONS IN THE TREATMENT OF COMPLETE ANORECTAL FISTULAS

Anorectal fistula is a pathological connection of the anal canal and rectum with the skin of the perianal area. The first stage in the treatment of anorectal abscess is the opening and drainage of the abscess by conducting a draining seton. It is the choice of the method and type of draining seton that is extremely important, because its installation and use, in some cases, can last more than a year. The problem of anorectal abscesses and fistulas has always been acute, because over the entire period of research on the subject, the recurrence rate averaged 30%, and the rate of development of complications in the form of anal sphincter insufficiency is still about 10%. Our research is aimed at improving the use of different types and methods of using setons in the treatment of anorectal fistulae. The aim of the study. To improve results in the use of draining setons in the treatment of anorectal fistulae. Material and methods. An analysis of the results of the treatment of 34 patients who were treated in the surgical clinic of the Medical Faculty No. 2 of the M.I. Pirogov VNMU in 2020-2023 was carried out. Results of the study. This study evaluated the available possibilities of using setons in the treatment of fistulas. The gold standard for us is the use of soft tissue MRI of the pelvis. Inadequate assessment of the prevalence of the process, incorrect tactics of surgical intervention and the use of a draining seton of the abscess passage without sufficient drainage of purulent soft tissue invasions led to disease recurrence and repeated operations. The main idea of using draining setons for us is the formation of a simple anorectal fistula, which will be operated on in the future with minimally invasive, high-energy techniques, in order to preserve the functional capacity of the sphincter apparatus of the anal canal and quick postoperative rehabilitation. Conclusion. Carrying out draining setons of the purulent course of anorectal abscesses is one of the stages of treatment of anorectal fistulas, which ensures the formation of a simple fistula, to which we can use minimally invasive, high-energy technologies and methods.