Khirurgiia · 2024
[Surgical treatment of perianal abscess and fistula-in-ano in neonates and infants].
СтатьяСравнительное исследованиеАннотация на английскомНазвание и аннотация: Перевод в очереди
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Ignat'ev V V, Shramko P V, Muraviev A V, Garapov T A, Tishukov M Yu
Аннотация
OBJECTIVE: To compare the incision and drainage of perianal abscess (ID) without fistulotomy with Gabriel procedure (GP) in neonates and infants with perianal abscess and fistula-in-ano.
MATERIAL AND METHODS: A single-center retrospective comparative study included neonates and infants aged 1-12 months with first occuring perianal abscess and fistula-in-ano. Postoperative follow-up was 1 year. Abscess with fistula was confirmed in all patients.
RESULTS: The study included 31 boys (13 ones in the ID group, and 18 ones in the GP group). Clinical characteristics were similar in both groups. The cure rate in the OG group (100%, 18/18) was significantly higher than in the ID group (54%, 7/13; p=0.002). Abscess recurrence was significantly less common in the OG group (p=0.002). No fecal incontinence was observed in any patient. We analyzed the factors affecting the incidence of perianal abscess and fistula-in-ano recurrence using the odds ratio and 95% confidence interval (CI). There was no correlation between recurrence rate and positive bacteriological examination of postoperative wound as well as type of feeding (OR 0.5; 95% CI 0.07 - 3.55; p=0.24, and OR 0.53; 95% CI 0.058 - 4.912; p=0.15, respectively).
CONCLUSION: Recurrence rate is significantly lower after GP for perianal abscess and fistula-in-ano.
MATERIAL AND METHODS: A single-center retrospective comparative study included neonates and infants aged 1-12 months with first occuring perianal abscess and fistula-in-ano. Postoperative follow-up was 1 year. Abscess with fistula was confirmed in all patients.
RESULTS: The study included 31 boys (13 ones in the ID group, and 18 ones in the GP group). Clinical characteristics were similar in both groups. The cure rate in the OG group (100%, 18/18) was significantly higher than in the ID group (54%, 7/13; p=0.002). Abscess recurrence was significantly less common in the OG group (p=0.002). No fecal incontinence was observed in any patient. We analyzed the factors affecting the incidence of perianal abscess and fistula-in-ano recurrence using the odds ratio and 95% confidence interval (CI). There was no correlation between recurrence rate and positive bacteriological examination of postoperative wound as well as type of feeding (OR 0.5; 95% CI 0.07 - 3.55; p=0.24, and OR 0.53; 95% CI 0.058 - 4.912; p=0.15, respectively).
CONCLUSION: Recurrence rate is significantly lower after GP for perianal abscess and fistula-in-ano.