Features of the formation of postoperative scars under the influence of rehabilitation programs in patients with chronic paraproctitis in the early postoperative period after minimally invasive surgical hospital-replacing technologies

Abstract

BACKGROUND: The study of the features of the formation of postoperative scars under the influence of rehabilitation programs in patients with chronic paraproctitis in the early postoperative period after minimally invasive surgical hospital-replacing technologies expands our understanding of the pathological condition and methods of its treatment.

AIM: To study the effect of various rehabilitation programs on the formation of postoperative scars in patients with chronic paraproctitis in the early postoperative period after minimally invasive surgical hospital-replacing technologies.

MATERIAL AND METHODS: The study summarized and analyzed the experience of surgical treatment of 180 patients with chronic paraproctitis using minimally invasive surgical hospital-replacing technologies and rehabilitation programs in the early postoperative period. Laser ablation of the fistula tract — the classic FiLaC technology was performed in 90 patients; modified FiLaC technology — 90. Each of the subgroups was divided into 3 groups: group 1 (main) included 30 patients who underwent a 4-component rehabilitation complex from the second day after the operation; group 2 (comparison) — 30 patients who underwent a 2-component rehabilitation complex from the second day after the operation and group 3 (control) — 30 patients, without an additional physiotherapeutic rehabilitation program. A comprehensive assessment of the features of the formation of postoperative scars was carried out as a criterion for the effectiveness of treatment, one of the tools of which was a complex transrectal ultrasound with color Doppler mapping, Dopplerography and sonoelastography at different stages of treatment.

RESULTS: All patients tolerated the course of treatment well: there were no cases of interruption of rehabilitation programs. The dynamic analysis of the data showed a statistically significant result: the best — in patients of the main group against the background of a 4-component rehabilitation program, the formation of postoperative scars accelerated, the formation of a mature scar occurred earlier, the risks of developing postoperative complications and relapses of the disease decreased.

CONCLUSION: The use of rehabilitation programs in patients with chronic paraproctitis in the early postoperative period after minimally invasive surgical hospital-replacing technologies can improve clinical results due to the complex physiotherapeutic effect. Complex transrectal ultrasound with color Doppler mapping, Dopplerography and sonoelastography in patients with chronic paraproctitis is an effective non-invasive diagnostic method: monitoring the formation of a postoperative scar and assessing the ongoing treatment.

Keywords

rectal fistula / chronic paraproctitis / anal fistula / physiotherapy / rehabilitation / comprehensive postoperative rehabilitation program / postoperative scars

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