Comparison of the results of treatment of acute paraproctitis in a specialized short-stay hospital and a general surgical hospital

Introduction. Acute paraproctitis (AP) is one of the most common diseases in emergency coloproctology that require emergency surgical treatment.

Аim. To conduct а comparative analysis of the results of surgical treatment of patients with AP in a specialized short-stay hospital (SSSH) and a general surgical department.

Materials and methods. A comparative prospective-retrospective non-randomized clinical study was conducted. The results of surgical treatment of 226 patients with AP were analyzed. In 118 patients (Group I), AP treatment was performed in the conditions of the SSSH (IMC "URO-PRO", Krasnodar), and in 108 patients (Group II) – in the conditions of a general surgical hospital in the system of municipal budgetary healthcare of the Krasnodar Territory. In patients of Group I, a transrectal ultrasound examination of the rectum and/or a magnetic resonance imaging of the pelvis were performed during the examination, and an intraoperative verification of the fistula was performed, and after the abscess was opened, an elastic theloose seton was placed through the surgical wound. In patients of Group II, only a routine clinical examination was performed, and the surgical treatment of AP waslimited to the opening and traditional drainage of the purulent cavity.

Results. In Group I, the average hospital stay was 12.89 ± 5.7 hours, while in Group II, it was 4.2 ± 1.56 days. In Group I, 6 (5.08%) patients developed postoperative complications, while in Group II, 14 (12.96%) patients experienced complications. In Group II, 19 (17.59%) patients had a recurrence of the disease, while no recurrence was observed in Group I patients, which was directly related to the formation of a controlled consolidated fistula along the drainageligature.

Conclusions. Surgical treatment of patients with AP in the conditions of the SSSH, in comparison with the general surgical department, allows to reduce the number of postoperative complications by 7.88% (p = 0.022), and also to exclude the risk of developing a disease relapse.

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