The choice of tactics of rehabilitation measures in patients with chronic paraproctitis, depending on the volume of surgical intervention based on quality of life indicators

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Abstract

BACKGROUND: The development of medical technologies puts forward requirements for the improvement and optimization of treatment and rehabilitation algorithms for providing surgical care to proctological patients and, in particular, patients with chronic paraproctitis. The criteria for the effectiveness of therapy are the period of wound healing, the frequency of recurrence of the disease and the preservation of the function of the anal sphincter. The development of minimally invasive surgical technologies is a new promising area of outpatient coloproctology.

AIMS: was to evaluate the effectiveness of the use of physiotherapy programs for postoperative rehabilitation according to the SF-36 quality of life assessment scale in groups of patients operated on by various methods of surgical interventions and to develop an Algorithm for surgical treatment and postoperative rehabilitation of patients with chronic paraproctitis.

MATERIAL AND METHODS: The study included observation and control in the pre- and early postoperative period for 270 operated patients with extra- and transsphincter pararectal fistulas with various options for surgical treatment and rehabilitation programs used in the early postoperative period. As a criterion of effectiveness, an assessment of the quality of life b according to the SF-36 questionnaire was used. The surgical-physiotherapeutic Algorithm of surgical treatment and rehabilitation of patients with chronic paraproctitis” is proposed for wide introduction into clinical practice.

RESULTS: As a result of the analysis of the data obtained, it was found that the quality of life depends on the type of operation: the advantage of using minimally invasive surgical interventions and the rehabilitation program used has been proven: the advantage of using an extended 4-component rehabilitation program has been proven.

CONCLUSION: The data obtained made it possible to determine the tactics of rehabilitation measures in patients with chronic paraproctitis depending on the volume of surgical intervention and display it in a visual, schematic form ― Algorithm for surgical treatment and rehabilitation of patients with chronic paraproctitis.

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About the authors

Sergey A. Kovalev

Petrovsky National Research Centre of Surgery

Author for correspondence.
Email: koseal@mail.ru
ORCID iD: 0000-0001-7697-3384
SPIN-code: 6268-9694

MD, Сand. Sci. (Med.), Associate Professor

Russian Federation, Moscow

References

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Quality of life indicators (SF-36) of patients with chronic paraproctitis after they underwent surgery using FiLaC technology, depending on the group of postoperative rehabilitation.

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3. Fig. 2. Quality of life indicators (SF-36) of patients with chronic paraproctitis after they underwent modified FiLaC, depending on the group of postoperative rehabilitation.

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4. Fig. 3. Quality of life indicators (SF-36) of patients with chronic paraproctitis after they underwent excision of the fistula passage with plasty of the internal fistula opening with a full-layer flap of the rectal wall, depending on the group of postoperative rehabilitation.

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5. Fig. 4. Algorithm of surgical treatment and rehabilitation of patients with chronic paraproctitis.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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