Свищи прямой кишки – это каналы, которые сообщают полость органа с окружающими тканями. Появление свищевых ходов не может считаться нормой, так как их возникновение всегда свидетельствует о деструктивном процессе в области прямой кишки.
Виды свищей
Свищи прямой кишки классифицируют по нескольким признакам.
По локализации
- Полные (наружные) свищи. Образования имеют два отверстия, одно из которых локализуется в стенке прямой кишки, а второе выходит на поверхность кожи параректальной области.
- Неполные (внутренние) свищи. Свищевые ходы имеют одно входное отверстие и заканчиваются слепо в клетчатке, окружающей кишечник.
По отношению к анальному сфинктеру
- Интрасфинктерные свищи. Свищевой ход проходит через края анального кольца, локализуется в подкожном слое. Образование не имеет разветвлений, поэтому считается наиболее простым из возможных вариантов патологии.
- Транссфинктерные свищи. Патологический ход формируется в области сфинктера и распространяется на клетчатку. В большинстве случаев при таком образовании формируются дополнительные гнойные карманы и разветвления. Течение заболевания сопровождается образованием рубцовой ткани в тканях, окружающих прямую кишку.
- Экстрасфинктерные свищи. Образование не затрагивает наружный анальный сфинктер и залегает глубоко в подкожной области. Наружное отверстие свища открывается на коже промежности.
По тяжести заболевания
- I степень (легкая). В прямой кишке формируется прямой свищевой ход. В окружающих тканях отсутствуют гнойные инфильтраты, признаки рубцовых изменений.
- II степень (средняя). В области внутреннего отверстия свища формируются рубцовые изменения, гнойных инфильтратов на данный момент нет.
- III степень (тяжелая). Образование характеризуется развитием воспалительно-некротического процесса, при этом рубцовые изменения в ткани отсутствуют.
- IV степень (очень тяжелая). Свищевой ход имеет широкое внутреннее отверстие, окруженное рубцовыми изменениями. В клетчатке вокруг образования формируются гнойные полости или инфильтраты, которые могут распространяться на обширные участки параректальной клетчатки.
Причины формирования
острый или хронический парапроктит;- последствие операции на прямой кишке;
- туберкулезное поражение пищеварительной системы;
- болезнь Крона;
- дивертикулярная болезнь кишечника и воспаление патологических отростков (дивертикулит);
- специфические инфекции (сифилис, хламидиоз, ВИЧ-инфекция и СПИД, актиномикоз);
- запущенное течение геморроя;
- родовые травмы у женщин (разрыв родовых путей, роды в тазовом предлежании, использование акушерского пособия, длительные роды);
- рак прямой кишки в терминальной стадии;
- в редких случаях – свищи ятрогенного происхождения (нарушение техники проведения гинекологических манипуляций).
острый или хронический парапроктит;Симптомы
- образование дефекта кожи в области анального отверстия или в промежности;
- патологические выделения крови или сукровицы;
- неприятный запах данных выделений;
- болезненность в области ранки;
- покраснение и мацерация кожи анальной области;
- при пальпации – заметное уплотнение в области прямой кишки, представляющее собой свищ, заполненный каловыми массами;
- ухудшение общего состояния пациента – общая слабость, бессонница, раздражительность, при тяжелом течении возможна субфебрильная температура (до 38 °С);
- нарушение отхождения стула, на поздних стадиях – нарушение мочеиспускания.
образование дефекта кожи в области анального отверстия или в промежности;Диагностика
- Общий осмотр. При осмотре аноректальной области проктолог может обнаружить одно или несколько выходных отверстий свища, которые имеют неровные края. Из кожных дефектов может выделяться кал или сукровица. При пальпации обнаруживается плотное образование в области отверстия. Это позволяет предположить наличие свища и поставить предварительный диагноз.
- Ректороманоскопия. Методика диагностики предполагает осмотр полости прямой и толстой кишки. В ходе диагностики можно обнаружить внутреннее свищевое отверстие.
- Колоноскопия. Эндоскопическое исследование также применяется для внутреннего осмотра кишечника и выявления дефекта слизистой стенки. Диагностика с помощью колоноскопии является более информативной, чем ректороманоскопия.
- Фистулография. Диагностика представляет собой рентгенологическое контрастное исследование свищевого хода. В патологическое образование вводится бариевая взвесь, после чего проводится серия рентгенологических снимков. Это позволяет оценить проходимость свищевого хода, обнаружить дополнительные разветвления и гнойные карманы.
- Компьютерная томография (КТ). Исследование относится к дополнительным методикам диагностики, которые применяются при сложных диагностических случаях. Компьютерная томография позволяет послойно визуализировать аноректальную область, что важно для уточнения локализации свищей и гнойных затеков, которые обязательно должны быть ликвидированы из параректальной клетчатки.
- Общий и биохимический анализ крови. Исследования проводятся для оценки общего состояния пациента и обнаружения возможных противопоказаний к проведению соответствующей терапии.
Общий осмотр. При осмотре аноректальной области проктолог может обнаружить одно или несколько выходных отверстий свища, которые имеют неровные края. Из кожных дефектов может выделяться кал или сукровица. При пальпации обнаруживается плотное образование в области отверстия. Это позволяет предположить наличие свища и поставить предварительный диагноз.
Фистулография. Диагностика представляет собой рентгенологическое контрастное исследование свищевого хода. В патологическое образование вводится бариевая взвесь, после чего проводится серия рентгенологических снимков. Это позволяет оценить проходимость свищевого хода, обнаружить дополнительные разветвления и гнойные карманы.Хирургическое лечение
Основная методика лечения прямокишечных свищей – это оперативное вмешательство. Консервативное лечение может быть использовано, но только в качестве сопутствующей терапии, подготавливающей пациента к операции.
Строго запрещено применять народные средства вместо обращения к врачу.
Гнойное воспаление, которое обязательно возникает при образовании свища, может распространяться на окружающие ткани, повреждать органы брюшной полости и малого таза. Поэтому заболевание требует обязательного врачебного вмешательства, которое должно быть произведено в кратчайшие сроки.
Порядок проведения вмешательства
Объем и радикальность производимой операции зависит от распространенности патологического процесса. Обычно процедура включает в себя следующие этапы:
- Обеспечение доступа к свищевому ходу.
- Иссечение тканей патологического образования.
- Ревизия окружающих тканей на предмет гнойных затеков и карманов.
- Иссечение найденных полостей.
- Установка дренажа.
- Пластика внутреннего отверстия свища с помощью слизисто-мышечного лоскута.
- Ушивание внешнего отверстия.
Операция проводится после обязательной госпитализации пациента. Для обезболивания в большинстве случаев используется общий наркоз, местная анестезия при данном вмешательстве неэффективна.
Послеоперационная реабилитация
Правильное ведение реабилитационного периода снижает риск развития послеоперационных осложнений. На послеоперационную рану пациенту накладывается повязка, через анальное отверстие в прямую кишку вводится специальная гемостатическая губка и газоотводная трубка. Через сутки после вмешательства делают перевязку, извлекают трубку. Во время перевязки обязательно проводится ревизия послеоперационной раны.
При сложных свищах с большим количеством гнойных карманов ушивание кожи сразу после операции не проводится. Необходимо провести повторную ревизию полости раны через неделю после вмешательства. Если новые патологические изменения не обнаруживаются, то проводится ушивание раны. Процедура также проводится под общей анестезией.
В первые несколько недель после операции пациент находится в отделении больницы, где ему проводят перевязки. Манипуляции с раной могут вызывать сильную боль, поэтому во время процедуры применяются местные анальгезирующие средства – гели или мази. В период реабилитации больному назначаются специальные сидячие ванночки с травяными отварами или другими лекарственными средствами. Такие процедуры помогают купировать боль и ускоряют заживление раны.
Диета после операции
Несколько часов после операции пациент не должен ничего принимать внутрь, после ему разрешается пить. В первые 2-3 дня можно употреблять только воду или кефир, а также немного отварного риса. Питьевая диета необходима для того, чтобы у пациента не мог образоваться оформленный стул. Каловые массы могут инфицировать послеоперационную рану, что приведет к рецидиву заболевания. Поэтому употребление твердых продуктов в этот период ограничено.
В дальнейшем пациент должен перейти на правильное питание:
- принимать пищу рекомендуется по 5-6 раз в день в небольших количествах;
- необходимо исключить из рациона все слишком жирное и жареное;
- не есть горячие и холодные продукты, придерживаться нормального температурного режима;
- запрещены газированные напитки, пряные и копченые блюда;
- рекомендуется включать в рацион большое количество овощей и фруктов, которые богаты клетчаткой;
- нужно употреблять больше кисломолочных продуктов, что способствует нормализации характера стула и восстановлению нормальной перистальтики кишечника.
Возможные осложнения
- рубцовые изменения в стенке кишечника;
- кровотечения из пищеварительной системы;
- недостаточность анального сфинктера, сопровождающаяся недержанием кала;
- озлокачествление (малигнизация) ткани прямокишечных свищей.
Прогноз для пациентов с поверхностными свищами обычно благоприятный, после оперативного вмешательства наблюдается стойкая ремиссия заболевания. При наличии глубоких свищей с наличием гнойных затеков риск развития осложнений значительно повышается, особенно при несвоевременном лечении.
Каждому человеку необходимо знать, как выглядит свищ заднего прохода, поскольку отклонение широко распространено и встречается у молодых и пожилых людей в равной мере. Свищ или фистула возле заднего прохода характеризуется возникновением своеобразного канала, в котором формируются гнойники. Свищ около заднего прохода сопровождается воспалительным процессом и другими симптомами, которые мешают нормальной жизни человека. Не следует пытаться вылечить проблему в домашних условиях, поскольку неправильными действиями можно лишь усугубить патологию. Необходимо обращаться к врачу и лечить свищ в заднем проходе медикаментами или оперативными способами.
ВАЖНО ЗНАТЬ! Даже "запущенный" геморрой можно вылечить дома, без операций и больниц. Просто не забывайте 3 раза в день наносить читать далее.
Этиология
Свищ прямой кишки появляется по разным причинам, которые провоцируют воспалительно-гнойный процесс в тканях органа. Выделяют следующие причины, влияющие на развитие свища в области ануса:
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- запоры хронического характера;
- геморроидальное поражение;
- анальные трещины;
- ослабленная иммунная система;
- злоупотребление спиртным;
- болезни инфекционной или вирусной этиологии;
- нарушения в эндокринной системе;
- атеросклероз;
- заражение крови;
- болезнь Крона;
- туберкулезное заболевание;
- злокачественная опухоль в прямой кишке;
- заражение хламидиями;
- ВИЧ или СПИД.
У мужчин развитие свища заднего прохода происходит при воспалительном процессе в простате.
Виды свищей заднего прохода
| Вид | Характеристика | |
| По наличию наружного отверстия | Неполный | Входная дырочка имеется, а выход отсутствует |
| Полный | Отверстие локализуется в прямой кишке и свищевой ход доходит до анального отверстия | |
| Внутренний | Начало отверстия расположено в прямом кишечнике, свищевой ход протягивается через соседние ткани и возвращается в прямую кишку | |
| По травмированию мышц сфинктера | Интрасфинктерный | Имеется одно наружное отверстие, состоящее из одного свищевого хода |
| Транссфинктерный | Несколько свищевых ходов, в результате чего образуются гнойные карманы и рубцы | |
| Экстрасфинктерный | Возникает 2—3 отверстия, которые берут начало в прямой кишке с выходом в задний проход |
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Характерные симптомы
Признаки анального свища довольно характерные и их сложно не обнаружить. Для свища заднего прохода характерно формирование одного или нескольких глубоких проходов. Внешне свищ напоминает гнойник или небольшую рану, после нажатия на которую выделяется кровянистая или гнойная жидкость. Для свища заднего прохода характерны такие симптомы:
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- зудящие и болезненные ощущения в области заднего прохода;
- отек в пораженной зоне;
- болезненный акт дефекации;
- периодические анальные абсцессы;
- кровоточит или гноится из заднего канала;
- раздражение вокруг заднего отверстия;
- дискомфорт при сидении.
Пациент может нащупать вокруг заднего канала уплотнение, напоминающее шишку. Внутри образования содержится жидкость, гной или каловые массы. При тяжелой стадии свища в зоне заднего прохода у человека отмечаются интоксикационные симптомы:
- лихорадочное состояние;
- быстрая утомляемость и постоянная усталость;
- головные боли;
- рвота и ощущение тошноты;
- повышение температуры тела.
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Диагностика
Определить анальный свищ у ребенка и взрослого самостоятельно достаточно сложно, поскольку проявления патологии напоминают и другие заболевания заднего прохода. Необходимо обратиться за помощью к терапевту или проктологу, который проведет осмотр пораженной области и назначит специальные диагностические манипуляции:
- ультразвуковую диагностику с использованием контрастной жидкости;
- фистулографию;
- использование пуговчатого зонда;
- введение контрастного вещества в полость прямой кишки и обследование органа;
- аноскопию.
Если у пациента отмечается тяжелое течение свища в заднем канале, сопровождающееся гнойно-воспалительным процессом, то дается направление на обследование у хирурга-проктолога.
ОБРАЩАЕМ ВНИМАНИЕ! Это домашнее средство поможет ВСЕМ, кому надоело страдать при каждом походе в туалет. Действует быстро и натурально, без уколов и операций! что же за средство >>
Как лечить?
Медикаментозное лечение
Лечение без операции не может дать долгосрочного эффекта, используя медикаментозные препараты, удается лишь купировать на время неприятную симптоматику. Чтобы избавить человека от болезненных ощущений и воспаления, врачи прописывают ректальные свечи:
Чтобы устранить дискомфорт врач может назначить Релиф Ультра в свечах.
- «Анестезол»;
- «Гепатромбин Г»;
- «Релиф Ультра»;
- «Постеризан форте»;
- ихтиоловые суппозитории.
Лекарство используется исключительно по назначению лечащего врача и в назначенной дозировке. Такие медикаменты также используются больными, которым по каким-то причинам запрещено оперативное удаление свища в заднем проходе. Если присоединилась бактериальная или грибковая инфекция, то прописываются антибиотики, подавляющие активность микроорганизмов.
Народная терапия
Вылечить свищ, сформировавшийся рядом с анальным отверстием, народными средствами невозможно. Используя природные компоненты, удается предотвратить осложнения, временно устранить воспаление и боль. Из целебных трав рекомендуется делать целебные ванночки, примочки, компрессы. Нетрадиционная терапия используется в комплексе с медикаментозным и оперативным лечением и только после согласования с доктором. Выделяют такие популярные рецепты против свища в заднем канале:
- Зверобой. Из компонента готовят настой на протяжении 5 минут, затем из кашицы делают компресс и прикладывают к травмированному месту. Процедура проводится каждый день до устранения симптоматики.
- Чайный гриб + корень подорожника. В готовый отвар из подорожника добавляют грибную настойку. В полученное средство окунают чистую марлю и прикладывают к заднему проходу.
- Ромашка + кора дуба + календула. Растения применяются для сидячих ванночек, которые купируют воспалительный процесс и помогают ранке затянуться.
- Алоэ + мумие. В растворенное в теплой воде мумие добавляют сок растения, тщательно перемешивают и с помощью марли средство наносят на пораженный участок.
- Оливковое масло + водка. Смешать 2 компонента и смазывать больные участки заднего прохода. После смазываний на пораженную зону накладывать лист капусты.
- Алоэ + мед. Измельченные листья алоэ залить медом и оставить на 8 суток настаиваться в темном месте. Когда средство будет готово, его отживают, смачивают марлю и вводят в задний проход.
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Оперативное лечение
Наиболее эффективное лечение свища у женщин и мужчин — хирургическое удаление. Операция является обязательной при гнойно-воспалительном процессе. При оперативном вмешательстве хирург удаляет полностью свищ и рядом расположенные ткани, чтобы не допустить рецидива. Удаление проводится под общим наркозом. В среднем восстановление длится 1—2 недели, в особо тяжелых случаях период реабилитации затягивается. После операции больным соблюдаются следующие правила:
- Придерживается особая диета, которая не допускает возникновение запоров.
- Для снятия болевых ощущений применяются обезболивающие медикаменты.
- Проводятся сидячие ванночки с целебными травами, чтобы не возникло инфицирования.
- Тщательное поддержание гигиеничности в области заднего прохода.
- Регулярное посещение врача, особенно при ухудшении состояния.
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В чем опасность?
Если своевременно не будет проведено оперативное или медикаментозное лечение, то возможны серьезные осложнения:
Недержание газов может быть из-за формирования рубцов на месте образований.
- формирование рубцов в области заднего прохода, которые приводят к недержанию газов и каловых масс;
- заражение крови;
- сильные болезненные ощущение при испражнении, при которых обильно выделяется кровь;
- нарушенная форма промежности и анального канала.
У пациентов с запущенным свищем в заднем проходе нередко развивается злокачественная опухоль, требующая особого лечения.
Профилактические рекомендации
Легче не допустить свищ, соблюдая профилактические меры, нежели его лечить. С этой целью требуется регулярно следить за чистотой тела, особенно областью промежности и заднего прохода. При появлении трещин в анале необходимо не затягивать лечение проблемы. Немаловажным является ежедневным рацион, который следует наполнить полезной пищей, предотвращающей запоры. Необходимо отказаться или сократить потребление мучных изделий, острых и жареных блюд. Также рекомендуется не злоупотреблять алкогольной и табачной продукцией, которые часто становятся источниками формирования свищей в анальном проходе. При первых проявлениях анальных свищей необходимо обращаться к врачу и не заниматься самолечением.
Вам» все еще кажется, что избавится от геморроя тяжело?
Судя по тому, что вы сейчас читаете эти строки — победа в борьбе с геморроем пока не на вашей стороне.
И вы уже думали о хирургическом вмешательстве? Оно и понятно, ведь внутренний организм у вас один, а его правильное функционирование — залог здоровья и хорошего самочувствия. Кровь на бумаге, постоянные мысли как бы уменьшить вздувшиеся болючие шишки, бессонница, поход в туалет как на каторгу. Все эти симптомы знакомы вам не понаслышке.
Но возможно правильнее лечить не следствие, а причину? Рекомендуем прочитать историю Михаила Сергеевича, как не навредив себе можно избавится от геморроя. Читать статью >>
Параректальный свищ возникает вследствие нарушения обменных процессов в клетчатке вокруг ампулы прямой кишки. Чаще всего, это происходит на фоне парапроктита или проктита, симптомом которого становится абсцесс клетчатки.
Основные проявления свища заднего прохода – гнойные или кровянистые выделения, боль, зуд, раздражение эпидермиса перианальной области.
Независимо от места локализации, параректальный свищ – это канал, соединяющий ампулу прямой кишки или область возле анального отверстия с близлежащими полыми органами.
Свищ прямой кишки – это следствие острого или хронического проктита, охватывающего анальные крипты (заднепроходные пазухи), пространство между сфинктерами и клетчатку вокруг прямой кишки. Анальная крипта, пораженная проктитом, становится одним из отверстий свища, расположенным в толще клетчатки.
Параректальный свищ характеризуется частыми рецидивами, он мучает больного, протекает с тяжелыми местными симптомами, значительно ухудшает общее самочувствие. Если заболевание длится достаточно долго, у пациента деформируется анальный сфинктер, возрастает риск развития онкологического поражения нижних отделов кишечника.
Классификация параректальных свищей
В зависимости от клинической картины различают следующие формы параректального свища:
Неполный свищ – разновидность, не имеющая выхода на поверхность. Канал заканчивается в параректальной клетчатке, это промежуточная стадия перед образованием полной формы. Если гнойные процессы развиваются, неполный свищ находит выход наружу, трансформируясь в полный.
Полный свищ имеет одно или несколько входных отверстий, которые начинаются на стенке прямой кишки, и одно выходное отверстие, заканчивающееся на коже возле анального отверстия.
Классификация по локализации относительно сфинктера:
Интрасфинктерная локализация – свищ имеет прямой канал, внутреннее отверстие в одной из крипт, наружное отверстие возле ануса.
Транссфинктерная локализация – свищ имеет разветвленные ходы, гнойные карманы в параректальной клетчатке, в окружающих тканях образуются рубцы. Канал свища располагается под кожей, на поверхности или в глубине сфинктера.
Экстрасфинктерная локализация – свищ возникает в результате острого парапроктита, имеет длинный извитой ход, несколько выходов. Внутреннее отверстие открывается в области заднепроходной пазухи (крипты).
Степень сложности экстрасфинктерного свища:
Первая степень – свищевой ход прямой и узкий, не возникает ни рубцов, ни инфильтрата, ни гнойников.
Вторая степень – внутреннее отверстие окружено рубцовой тканью, признаки воспаления отсутствуют.
Третья степень – рубцовой ткани нет, в клетчатке развивается воспалительный процесс с образованием гноя.
Четвертая степень – свищ имеет расширенное внутреннее отверстие, инфильтраты, рубцовую ткань.
Причины появления свища прямой кишки
Подавляющее большинство случаев появления патологии – это осложнение острого парапроктита. Из-за проникновения инфекции в параректальную клетчатку в стенке ампулы прямой кишки образуется абсцесс. Когда он вскрывается, формируется свищевой ход. Такое осложнение диагностируется, если больной несвоевременно обращается к врачу, или хирург ограничивает радиус оперативного вмешательства.
Заболевания или состояния, приводящие к появлению свища:
Травма или резекция прямой кишки;
Тазовое предлежание плода, разрывы родовых путей;
Осложнение после гинекологических операций;
Туберкулез прямой кишки;
Рак прямой кишки;
Дивертикулез прямой кишки;
Симптомы свища заднего прохода
В начале заболевания на коже возле ануса появляется отверстие свищевого хода. Из него выделяется гной и сукровица, они пачкают белье, и эти следы невозможно не заметить. Больному приходится пользоваться прокладками, мыть перианальную область, принимать сидячую ванну. К этим симптомам присоединяется зуд, мацерация кожи из-за постоянного воздействия выделений, неприятный запах.
При хорошем дренаже свища боль ощущается слабо. Она усиливается при хроническом воспалении неполного свища, становится интенсивной при дефекации, кашле и долгой ходьбе.
Периоды обострения сменяются периодами ремиссии. Обострение возникает, если свищевой ход закупоривается гнойной массой, продуктами некроза и грануляции. Вследствие этого образуется абсцесс, он спонтанно вскрывается, и отделение гноя и сукровицы временно уменьшается. Несмотря на это, наружное отверстие свища никогда не заживает, спустя некоторое время обострение повторяется.
Во время ремиссии, если пациент тщательно соблюдает гигиену, он не ощущает сильных болевых или неприятных симптомов.
Тем не менее, заболевание длительного течения с частыми обострениями оставляет следующие симптомы:
Изменения тканей, возникающие вследствие длительного течения сложных форм заболевания:
Недостаточность анального сфинктера;
Деформация анального канала;
Рубцы мышц сфинктера;
Пектеноз – рубцевание канала ануса;
Стриктура анального канала.
Диагностика
Полный свищ можно диагностировать при визуальном осмотре. На коже возле ануса пациента имеется отверстие свища, из которого выделяется гной и кровянистая слизь. Если свищ имеет одно отверстие – это последствие острого парапроктита. Два отверстия свищевого канала справа и слева от ануса – симптомы подковообразного параректального свища.
Зависимость характера выделений от формы свища:
Желтый гной без запаха – состояние после парапроктита;
Обильные жидкие выделения – туберкулезное поражение;
Скудные крошковидные выделения – свищ после актиномикоза;
Кровянистые или сукровичные выделения – возможные последствия озлокачествления свищевого процесса.
Если свищ принял неполную форму, при ректальном пальцевом исследовании обнаруживается единственное внутреннее отверстие. Женщин, страдающих от этого заболевания, обязательно осматривает гинеколог для исключения свища влагалища.
Дополнительные методы диагностирования и их назначение:
Зондирование – определение направления и разветвления свища, его локализации относительно сфинктера;
Аноскопия – изучение формы и протяженности свищевого канала;
Фистулография – рентгеновское исследование с контрастным веществом для выяснения объема свища;
Ректороманоскопия – оценка состояния слизистой, выявление опухолей;
Ирригоскопия – дифференциация от заболеваний со схожими симптомами (киста параректальной клетчатки);
Сфинктерометрия – изучение функциональности анального сфинктера;
Ультрасонография – проведение комплексной диагностики.
Лечение свища прямой кишки
Для полного излечения от свища существует единственный радикальный метод – это хирургическое вмешательство. Операция не проводится при закрытии отверстий во время ремиссии, потому что в этом случае невозможно оценить пораженную область, можно повредить здоровые ткани, или не полностью иссечь свищевой ход.
При обострении парапроктита хирург вскрывает абсцесс, ликвидирует гной, назначает больному лечение антибактериальными средствами. Дополнительно применяют физиотерапевтические процедуры (УФО, электрофорез). Как только воспалительный процесс стихает, проводится иссечение свищевого канала.
Методики оперативного вмешательства:
Рассечение свища в просвет прямой кишки;
Вскрытие гнойных затеков;
Закрытие свищевого отверстия лоскутом собственной мышечной и слизистой ткани.
Хирург выбирает технику проведения операции в зависимости от степени поражения и локализации свища относительно сфинктера.
После операции могут возникнуть осложнения в виде недостаточности анального сфинктера, а также рецидивы заболевания. Их вероятность значительно уменьшается при своевременно начатом лечении и правильной технике операции.
Прогноз и профилактика появления параректального свища
Хорошо поддаются лечению и редко рецидивируют интра- и транссфинктерные свищи невысокой локализации. Глубокие экстра- и транссфинктерные свищи характеризуются длительным течением болезни и частыми рецидивами.
Чтобы избежать появления патологии, нужно постараться исключить травмы прямой кишки, своевременно лечить парапроктит.
Автор статьи: Волков Дмитрий Сергеевич | к. м. н. врач-хирург, флеболог
Образование: Московский государственный медико-стоматологический университет (1996 г.). В 2003 году получил диплом учебно-научного медицинского центра управления делами президента Российской Федерации.
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