[Surgical treatment of anal insufficiency].

Organic defects in the lateral walls of the rectal obturative apparatus involving no more than one fourth of its circumference are repaired by end-to-end or side-to-side sphincteroplasty. Sphincterolevatoroplasty is indicated in anterior or posterior defects and sphincterogluteoplasty with short or long grafts of the greatest gluteus muscles in larger defects. For cases in which the gluteal muscles cannot be used, an operation has been developed for repair of the defects with the medial part of the great adductor muscle.

[A comparative study of nonsurgical methods in the treatment of hemorrhoids].

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.

[Surgical treatment of recto-vaginal fistulas].

The article discusses 15-year experience in the treatment of 280 patients with various forms of rectovaginal fistulas. The choice of the operative method was differentiated on basis of complex appraisal of the etiology of the disease, pronouncement of the cicatricial and inflammatory changes, the level of the communication, relation of the fistula to the sphincter ani, and the functional condition of the rectal obturator apparatus. Most of the patients were subjected to combined interventions--excision of the fistula and local myoplasty (62%).

[Clinical course and treatment of traumatic rectal fistula].

From experience in treatment of 104 patients with rectal fistulas of traumatic origin the authors distinguished the specific features of the clinical manifestations of the disease which must be taken into consideration in choosing the therapeutic tactics. In contrast to the management of common chronic paraproctitis, the treatment of traumatic rectal fistulas differs in principle, particularly when the internal opening of the fistula is in the wall of the rectal ampulla++. The authors determined the indications for various methods of treatment and techniques of operative interventions, including multistage surgical treatment with the creation of temporary colostomy.