INTRODUCTION: Patients with anorectal abscesses (ARAs) represent the most common proctological emergency in the anorectal area. Their wide distribution leads to clinical variety in the type and expression of inflammatory changes in the anorectal area.
AIM: The aim of this article is to carry out a study of different surgical methods in order to improve the effectiveness of operative treatment in patients with ARA.
MATERIALS AND METHODS: A total of 254 operated adult patients with ARA were studied, of whom 194 (76.4%) were males and 60 (23.6%) were females. The following operative methods were used: incision, revision, and drainage in 137 patients (53.9%), incision, revision, primary fistulotomy with cryptectomy and drainage in 48 patients (18.9%), and incision, revision, with ligation fistulotomy and drainage in 69 patients (27.2%). The average age of the operated patients was 49.57±16.12 years.
RESULTS: The ARA types were subcutaneous in 63 patients (24.8%), intersphincteric in 62 patients (24.4%), ischiorectal in 88 patients (34.7%), and supralevator in 41 patients (16.1%). Superficial ARA was found in 107 patients (42.1%), and deep ARA was diagnosed in 147 patients (57.9%).
CONCLUSION: The definitive operative treatment was applied in patients with incision, revision, and one-time liquidation of the internal opening by primary or ligation fistulotomy, leading to timely healing without disease chronicity. The principles of necrosectomy and sphincter-preserving manipulations near the external anal sphincter in the treatment of different ARA types should always be a must.
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