[Chronic recurrent paraproctitis]

Area of Science:

• Colorectal Surgery
• Proctology
• Surgical Infections

Context:

• Chronic paraproctitis, often presenting as recurrent pararectal abscesses without a fistula, poses a significant clinical challenge.
• Current understanding of etiology and treatment for these recurring abscesses is crucial for effective prophylaxis.
• The condition, characterized by remission stages with abscesses but no fistulas, is proposed to be termed 'chronic recurring paraproctitis'.

Purpose:

• To analyze the prophylaxis of chronic paraproctitis (rectum fistulas).
• To evaluate the efficacy of a novel two-step surgical operation for chronic recurring paraproctitis.
• To identify the necessary components for radical treatment to prevent recurrence.

Summary:

• A study involving 202 patients demonstrated that simple abscess drainage is not a radical treatment for chronic recurring paraproctitis.
• The proposed radical treatment involves a two-step operation with mucous membrane displacement to eliminate the altered crypt and latent infection.
• This surgical approach was performed on 119 patients, resulting in complete recovery and absence of recurrence.

Impact:

• Establishes a new nomenclature, 'chronic recurring paraproctitis,' for a specific clinical presentation.
• Provides evidence for a more effective surgical strategy in managing complex perianal sepsis.
• Offers a solution for preventing recurrence in patients with chronic paraproctitis, improving patient outcomes.