[Efficacy of application of sphincter-preserving surgeries in the treatment of complex rectal fistulas].

The methods of sphincterpreserving operative interventions, and a principally new algorithm of treatment was elaborated for enhancing of the treatment efficacy in patients, suffering complex rectal fistulas. There were examined 291 patients, ageing 20 - 62 yrs old, all of whom operated on in Odessa Rural Clinical Hospital in 2003 - 2014 yrs for complex transsphincteric and extrasphincteric rectal fistulas. In 120 patients (I clinical group) a ligature method in accordance to standard procedure was applied; in 108 (II group)--a plastic method with transposition of mucosa-submucosal flap in accordance to original procedure; in 63 (III group)--a method of intrasphincteric ligature of complex rectal fistulas. Application of plastic method of intrasphincteric ligature of complex rectal fistulas have permitted to omit the anal incontinence, to reduce the unemployment period in 2 - 2.5 times. But a recurrence rate after sphincterpreserving operations is certainly bigger: while a ligature method application--by 5%, of a plastic one--11.1%, of intrasphincteric ligature--9.2%. Application of elaborated algorithm for the patients treatment for complex rectal fistulas have promoted preservation of high quality of life in 96.3% patients, as well as reduction of rate of their disabling.