[Significance of nontraumatic anal sphincter relaxation for the success of plastic and miniinvasive interventions in coloproctology].

The investigation objective was to estimate the role of nontraumatic anal sphincter (AS) stretching, as a leading factor of success in minimally invasive and/or plastic proctological interventions. One-centre randomized investigation was performed in 83 patients: In 22 of them the AS fissura was revealed (in 16), suprasphincteric fistula (in 3) and coexistent rectocele 2-3 Ap (according to POP-Q classification) with thinning of the AS anterior segment, the degree III hemorrhoids and anterior AS fissure presence. Ninety units of botulotoxin preparation (Disport) were injected between internal and external AS portions 5-15 days preoperatively. The treatment results without botulotoxin injection were compared retrospectively. After botulotoxin injection performance the AS spasm elimination was noted, leading to the pain subsiding promotion before and postoperatively in all the patients observed. The spasm elimination have permitted to escape the anal high fistula recurrence as a result of the mucosal flap shift after intraluminal closure of the fistula or because of the fistula intermuscular electrowelding "suture" rupture, also have guaranteed the plastic sutures on AS, even while the stage II-III rectocele presence, not depending of performance of its simultant surgica correction.

[Optimization of modern tactics of operative treatment for hemorrhoids of stages III-IV].

The literature review and results of observations of their own, concerning treatment of patients with hemorrhoids, are adduced. Separation of circular and segmental forms of coexistent prolapsus recti permits to choose pathogenetically substantiated method of operative intervention for the hemorrhoidal nodes enlargement. Performance of the sun-like circular anorectal vasomucosectomy in the treatment of circular prolapsus recti, coexistent with enlargement of hemorrhoidal nodes, secures the pathological blood flow disconnection, the pain intensity and sphincteric spasm reduction, permits to escape postoperative inflammation, which is characteristic for procedure of the apparatus circular anorectal vasomucosectomy.

[Pelvic imaging modified by rectum predefecatory distension]. / Promeneve doslidzhennia maloho taza v umovakh peredvyporozhniuval'noho rozshyrennia priamoï kyshky.

Computed tomography (CT) rectum imaging limited by anatomy, pathological process and CT own characteristics. The ways of image improving are: endorectal scanning, myorelaxatives, contrast substances. Rectum and anal canal has oval serrated profile without distension on CT and US scans. Purpose is to improve the CT and endorectal US scan role in pelvic structure changing disorders operating plan estimating.