Surgical Treatment of Rectal Fistulae Using Biowelding

Background and Aim of Study: Rectal fistulae make 20% of all proctologic pathology. Despite numerous methods of surgical treatment of rectal fistulae, percentage of recurrence does not tend to decrease. Complicacy of surgical correction consists in balance between radical surgery with total resection of fistulae and minimal damage of anal sphincter. Development and implementation of novel mini-invasive methods of surgical treatment remains actual in surgery. The aim of the study: to compare and analyze results of treatment of transsphincter rectal fistulae using standard methods and using biowelding. Materials and Methods: We carried out retroand prospective research of surgical treatment of 57 patients with transsphincter rectal fistulae. All patients were treated in surgical development during September 2018 to November 2019. All patients were divided into two groups. First group included 30 patients, treated with standard methods (resection of fistula with sphincterectomy and incision of rectal fistula with sphincteroplasty). Other group included 27 patients, who were treated with biowelding. Results: According to data, satisfactory result of treatment in first group was observed in 66.7% of cases; in second group success was in 96.3%. Usage of biowelding for removal of intrasphincter part of fistula allowed both decreasing of surgery duration and preventing damage of sphincter apparatus. Conclusions: Excision of rectal fistulae using biowelding can be effective for treatment of such patients. Usage of this method allowed avoiding damage of sphincter apparatus, shortening time of wound healing and number of hospital stay, decreasing expression of pain syndrome in postoperative period.