[The treatment of an acute paraproctitis]

The results of surgical treatment of an acute paraproctitis in 708 patients, in 9 (1.27%) of whom gangrenous -- putrificated form of paraproctitis was diagnosed, are adduced. In 187 (42.6%) patients the abscess disclosure with intraintestinal purulent fistula, going into intestinal lumen, excision was performed, together with cryptectomy -- in 182 (41.4%), the ligature method was applied in 18 (4.1%) with subsequent fistula excision and its internal orifice plasty using mucosal-submucosal flap. For extrasphincteric or transsphincteric purulent tunnel the abscess was opened and drained, its internal orifice sutured, using 'distant" removable suture. It internal orifice was not revealed there was accomplished procedure of disclosure and draining of purulent cavity, the wound sanation with insufflation of ozone-oxygen mixture. In anaerobic paraproctitis the procedure consisted of disclosure and draining of purulent cavities with necrectomy was performed. To all the patients antibacterial therapy was conducted. In 20 (4.5%) patients an acute paraproctitis recurrence had occurred, in 9 (2%) -- pararectal fistula, and in 5 (1.1%) -- the anal sphincter stage I insufficiency.