Laser technologies in treatment of posttraumatic rectal fistulas

Abstract

AIM: To assess the results of surgical treatment of posttraumatic rectal fistulas using current laser technology. MATERIAL AND METHODS: Surgical treatment of 134 (10.9%) patients with posttraumatic rectal fistulas was analyzed. The control group of conventional treatment included 58 (43.3±3.4%) patients, the main group - 76 (56.7±3.4%) patients. In the main group we used carbon dioxide laser device 'Lancet-2' (Russia) with a wavelength of 10.6 microns, capacity up to 20 W, and contact laser device 'Atkus-15' (Russia) with a wavelength of 0.81 microns and output power up to 15W. In postoperative period all patients underwent daily infrared laser irradiation of wound surface with an exposure of 5-10 min, wavelength of 0.635±0.005 microns, output power 25 mW ('UZOR-3 KS' (Russia, Kaluga)). RESULTS: The complex surgical treatment with modern laser technologies have reduced the incidence of complications from 19.0±5.1% to 7.9±3.1% (OR=0.37; 95% CI; 0.13-1.06, p<0.05). The long-term results improved in 50.0±13.4% of the control group and in 77.8±6.9% of the main group (χ2=5.22; p<0.05). CONCLUSION: Thus, laser technology has reduced twice the number of postoperative complications and improved long-ter. RESULTS: 98.2% of patients achieved medical and social rehabilitation in main group and 96.4% of patients in control group.