MRI IN THE OBJECTIVE ASSESSMENT OF NEW NONINVASIVE METHOD OF TREATMENT OF COMPLEX ANAL FISTULAS

Аннотация

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Background. Anal fistulas are one of the most widespread colon diseases, their frequency is from 15 to 30%, their treatment is very difficult and actual problem. Now there are a lot of non-invasive methods of treatment of this pathology, therefore an algorithm of objective assessment of results is needed. Aim. To study possibilities of MRI in theobjective assessment of new non-invasive method of treatment of complex anal fistulas. Material and Methods. We selected the patient with extra-sphincter recurrent anal fistula, which was treated by the new non-invasive method - sclerotherapy with ultrasound influence. We used MRI for the objective assessment of results of healing. Results and Discussion. The reason of anal fistula’s recurrence was identified due to MRI. We found retro-rectal cavity and used the new method of sclerotherapy with ultrasound influence. MRI was performed again after 1 month and the positive dynamic was registered. The sclerotherapy of fistula was repeated like a second step of treatment. The patient underwent MRI within 1 year after the first assessment and the process of healing was indicated. On the MRI series the fibrosis and reducing of inflammation was detected. In other group of patients with complex anal fistulas we have good results of using of new non-invasive method. Recovery rate was 85.94% (55 patients),recurrence rate was 12,5% (8 patients).Only 14,06% (9 patients) were operated, but we noted during operations that inflammation of soft tissues was less after the sclerotherapy with ultrasound influence. Conclusions. MRI is an effective and informative method for objective assessment of new non-invasive method of treatment of complex anal fistulas.