Modern surgical methods of rectocele treatment – laser method

Introduction. Surgical treatment of rectocele by traditional methods (muscle plastic surgery and resection of stretched mucosa) is characterized by the risk of complications in the form of bleeding, suppuration, suture divergence (17–30 %), the frequency of relapses (5–35 %), unsatisfactory treatment results (5–85 %). It is characterized by technical complexity and duration of operations, low quality of life in the immediate postoperative period, long-term rehabilitation. These facts determine the need to search for new solutions in surgical tactics of the disease with improved results and increased treatment efficiency. Purpose of the study. To study the efficiency and safety of a new method of surgical treatment of rectocele – combined laser correction of rectocele. Materials and methods. Study group: 72 patients with lower anterior rectocele of 1–2 degrees. All patients were women aged 28 to 72 years. Exclusion criteria: severe concomitant pathology, purulent diseases of the anal canal. Most patients had concomitant hemorrhoids of stages 1, 2, 3, 4. Surgical treatment was performed under intravenous anesthesia with the addition of local anesthesia. Laser radiation of a diode device with a wavelength of 1,56 mkm and a power of 10 W was used. Results. Low (up to 5 points on VAS in 90 %) and short-term (taking NSAIDs 1–2 times a day for no more than 10 days in 90 %) postoperative pain syndrome. Rare complications (2 % of bleeding due to non-compliance, skin fringes). Satisfactory rehabilitation periods (30–40 days in 90 %). High quality of life in the immediate postoperative period. Low percentage of relapse during observation for 1 year (less than 5 %). High satisfaction with treatment (more than 95 %). Conclusion. The method has significant prospects for use in patients with initial stages of lower rectocele. It is characterized by high efficiency and safety. It can be used in outpatient surgery. It has no significant limitations if the rules for selecting patients for treatment are followed. It is simple and fast in technical execution.