[X-ray study in the examination of patients with perineal fistulas]. / Rentgenologicheskii metod v obsledovanii bol'n"kh so svishchami promezhnosti

The paper discusses whether X-ray study of patients with perineal fistulas is required and justified. The main reason is that there is a diversity of diseases which display the same signs as paraproctitis. Of 426 examinees, perineal fistulas were mainly caused by chronic paraproctitis in 85% and by other various diseases showing the similar symptoms in 15%. The basic studies of these patients included fistulography made in 300 patients with external fistulas and proctofistulography performed in 126 patients with incomplete internal fistulas. Comparing the data of X-ray study with those of clinical and morphological ones showed the sensitivity of the former to be 94.5%. Based on the results of their own observations, the authors defined indications for fistulography or proctofistulography. In addition to the analysis of the findings, they present the main points of differential X-ray diagnosis of different diseases manifested by perineal fistulas.

[A comparative study of nonsurgical methods in the treatment of hemorrhoids]. / Sravnitel'naia otsenka neoperativnykh metodov lecheniia gemorroia.

The authors conducted comparative appraisal of the results of treatment of hemorrhoids in 3 groups of patients at a higher surgical risk in 1989-1990. Group 1 consisted of 79 patients given the traditional nonoperative treatment. Group 2 was made up of 17 patients in whom the hemorrhoidal nodes were ligated by means of latex rings. Forty-three patients of group 3 were treated by the traditional nonoperative methods and, in addition, by infrared photocoagulation, 33 at in-patients and 10 at out-patient clinics. The follow-up periods range from 3 to 12 months. The study showed that nonoperative therapy produced a temporary effect, clinical manifestations of hemorrhoids recurred in 100% of patients. In group 2 59% of patients were cured, which is evidence of the pathogenetic substantiation of the method. The treatment, however, in this group was marked by a great number of complications of an inflammatory character. The best effect was produced among patients of group 3; 37 (86%) patients were cured. Thus, the results of comparative analysis of the efficacy of these methods of treatment in patients at a higher surgical risk showed the advantages of infrared photocoagulation over nonoperative treatment and ligation of hemorrhoids with latex rings. The method of infrared photocoagulation is technically simple, convenient, and can be applied both in in- and out-patient clinics.