CLINICAL AND ORGANIZATIONAL ASPECTS OF PARAPROCTITIS MANAGEMENT IN THE ABAY REGION OF KAZAKHSTAN

Paraproctitis is a common proctological condition that can present in acute or chronic forms, each requiring distinct diagnostic and therapeutic approaches. However, there is limited comparative data on the clinical and organizational characteristics of these forms. The purpose of this study is to conduct a retrospective analysis of medical care for patients with paraproctitis in the Abay region.

A retrospective cross-sectional study was conducted using data from 453 patients treated for paraproctitis at the University Hospital of NAO "MUS" from 2019 to 2024. Patients aged 18 years and older were included, with diagnosis confirmed by clinical, laboratory, and instrumental methods. Exclusion criteria were age under 18, presence of other diseases. Statistical analysis was performed using SPSS 24.0, with p<0.05 considered significant.

A total of 453 patients were included in the study, of whom 68% had acute paraproctitis and 32% had chronic forms. Males predominated in both groups (83.8%), and most patients were aged 18-44 years. Urban residents accounted for the majority of hospitalizations (77.9%). All patients underwent surgical treatment; abscess drainage prevailed in acute cases (91.2%), while reconstructive procedures were more frequent in chronic cases. Conservative therapies such as physiotherapy, strengthening treatment, and diet No. 3 were significantly more common in chronic cases (p<0.0001). Complications occurred more frequently in acute cases, especially wound infections (74.9%) and bleeding (42.3%), while fecal incontinence and rectovaginal fistulas were more common in chronic disease. The mean hospital stay did not differ significantly between groups; however, mortality was observed only in the acute group (1.6%, p<0.0001). Full recovery was more frequent in chronic cases (53.1%), whereas clinical improvement prevailed in acute cases (83.8%).

Acute and chronic paraproctitis differ significantly in clinical presentation, treatment approaches, complication rates, and outcomes. These findings emphasize the importance of tailored treatment strategies and early intervention to reduce complications and mortality.