Ethiology and pathogenesis of rectal fistulas
Relevance and scientific novelty. The etiology of complex rectal fistulas has not been fully studied, which hinders the stage of analysis and the selection of the most optimal treatment tactics for this pathology, as a result of which a huge number of people suffer. The article presents the results of a study on the etiology of transsphincteric and extrasphincteric I-II degree of complexity of the anorectal fistula of the rectum. The practical justification of the modern etiological theory of complex rectal fistulas is given, which reflects not only the theoretical contribution, but also practical, since the recommendation contained in the study to further study the etiology of the rectal fistulas will improve the quality of analysis and choice of treatment tactics for complex rectal fistulas.Objective. Identification of the etiology and pathogenesis of complex transfinkter and extrafinternal fistulas of the I-II degree of complexity of the rectum.Material and methods. The present work is based on the analysis of observations and treatment of 317 patients with transphincteric and extrasphincteric, I-II degree of complexity, rectal fistulas, who were hospitalized in the Proctology Department of the National Hospital under the Ministry of Healthcare of the Kyrgyz Republic. Among the sick men there were 262 (82.6%) and women 55 (17.4%). Most of the patients were between the ages of 20 and 59 years old - 297 (93.1%) and most often at the most working age, there are between the ages of 20 and 49 years - 255 (80.4%). The material for microbiological research was a detachable fistula, which was taken in a sterile tube and delivered immediately to the bacteriological laboratory.Results. The results of the study showed that Escherichia coli was sown more often, which was sown in monoculture in 44.8% of cases and in association with staphylococci in 14.2% of cases. In monoculture, staphylococci were found in 32.5% of cases, and in association with protea - 3.8%. Conclusions. 1) Paraproctitis, as a rule, occurs in people of the youngest, most able-bodied age from 20 to 59 years - 297 (93.1%). Among the patients, males 262 (82.6%) and women 55 (17.4%) predominate. 2) The results of microbiological research that we obtained have confirmed the literature data indicating that in chronic paraproctitis, E. coli and staphylococcus are most often sown. 3) Isolated microflora showed a relatively high resistance to penicillins, including semisynthetic, chloramphenicol and tetracycline, while maintaining high sensitivity to cephalosporins and aminoglucosides.