RU1819637C - Method for treating epithelial coccygeal passage - Google Patents

Abstract

Usage: in proctology. SUMMARY OF THE INVENTION: The coccygeal passage is cut longitudinally along its contour with a focused beam of a CO 3 laser. they clean the bottom of the coccygeal passage and evaporate the altered tissues of the cavity, pockets and fistulous passages with a defocused beam of a CO3 laser with a power density of 10-20 W / mm2, the wound remains open and is stored under a coagulation film for three days protecting it from microbial infection. Positive effect: allows a treatment period of 2-2.5 times.

Description

The invention relates to the field of medicine, namely to proctology.

The purpose of the invention is to reduce the treatment time, to prevent relapse of the disease and postoperative complications.

The proposed method is carried out as follows.

After treatment of the surgical floor with potassium iodonate, hair is shaved around the pathological focus. After repeated treatment of the surgical procedure, local anesthesia is performed with 0.5% novocaine solution. The first stage of the operation consists in determining the epithelial course by introducing a solution of brilliant green with the addition of a 3% solution of hydrogen peroxide in an amount of 0.5-2.0 ml. The contours of the epithelial passage, cavity, and direction of passage are determined. The operative field is covered with wet wipes. Next, a section is made longitudinally of the epithelial-coccygeal passage: with a focused beam of a COa laser. The radiation power of the scalpel is 80-100 W, the distance from its end to the wound is 2-3 cm, the exposure, depending on the length of the incision, is in the range of 10-30 s. After that, the surgical wound is expanded with a retractor for subsequent treatment. Next, use the Volkman spoon to clear the open cavity of the passage from. ox wasps, suppurations and altered tissues. The cavity is washed with a 3% hydrogen peroxide solution. Then, exposed deep-lying tissues, cavities, and fistulous passages are sequentially evaporated by a defocused beam of a CO3 laser with an irradiation density of 10–20 W / mm2 along a circular, spiral, or serpentine path with a speed of 1-3 mm / s with an exposure at one point of no more than 1-2 with. If necessary, the evaporation procedure is repeated up to three times. After the retractor has been removed, an antiseptic dressing moistened with rivanol solutions is applied to the open pH and is periodically renewed until it is completely healed.

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Example 1. Patient E., 26 years old. Diagnosis: chronic epithelial coccygeal passages. Complaints of moderate pain in the coccyx and periodic serous separation from fistulas. Sick for two years. Operated in a hospital twice. After processing the surgical floor with potassium iodonate, the hair was shaved around the pathological focus. After repeated treatment of the operating floor, local anesthesia was performed with a 0.5% solution of novocaine in an amount of 160 ml. After administration of a brilliant green solution with addition of a 3% solution of hydrogen peroxide in an amount of 1.5 ml, 4 fistulous passages were determined. Fistulous passages were located longitudinally: one in the upper three - in the lower pole. The surgical field is surrounded with wet rivanoleous napkins. A section is made of the focused beam of a carbon dioxide laser along the longitudinal contour of the epithelial coccygeal passages with a distance of 2-3 cm and an area of 80 watts. Beam exposure 25 s. The surgical wound was expanded with a retractor for subsequent processing.

Next, with a spoon of Volkman, the contents of the cavity of the hair, changed tissue / cleaned. The cavity is washed with a 3% hydrogen peroxide solution. A defocused carbon dioxide laser beam with a density of 20 W / mm2 is deeper burnt, changing tissues along the incision, cavities, fistulous passages are evaporated three times by the action of a defocused beam. Check on ge. bridge After removal of the expander, an aseptic dressing with rivanol was applied. The surgical wound remained open. The coagulation film formed is left untouched for three days to naturally reject it. The postoperative period was uneventful and the wound healed by primary intention. The period of incapacity for work is 11 (eleven) days. After 2.5 years, the disease does not recur.

PRI me R 2. Patient M .. 21 years. Diagnosis: acute epithelial coccygeal passage. Complaints of intense pain in the coccyx, weakness, malaise, subfibril temperature (37.4 gr.). Sick for 7 days. .

Preparation of the operating floor is normal. Local anesthesia with a 0.5% solution of novocaine in the amount of 100 il. An abscess cavity was punctured, 80 ml of serous-purulent fluid was released. Before the cut, 2 ml of brilliant green with 3% hydrogen peroxide in the amount of 0.5 ml was introduced into the cavity. 3 fistulous passages were determined. One fistulous

the stroke is located in the upper pole of the abscissa, two in the lower. The surgical field is surrounded around with wet rivanole wipes. Cut with a focused carbon dioxide laser beam.

longitudinal contour of the eye with epithelial-coccygeal passage with a distance of 2-3 cm, a radiation power of 100 watts. Beam exposure 20 s. The surgical wound was expanded with a retractor for subsequent processing. Next is Volkman's spoon

cavity contents (hair changed

tissue, purulent fluid) are cleaned. Cavity

was washed with 3% peroxide solution

hydrogen. The defocused carbon dioxide laser beam with a radiation density of 20 W / mm2, the underlying narcotic tissues, cavities, and passages along the section were evaporated by three times. Checked for hemostasis. The coagulation film formed is left untouched. The surgical wound remained open. An aseptic dressing with rivanol was imposed. The postoperative period went smoothly and the wound healed primary

tension. Disability period is 15 days. A turn of 2.5 years of disease recurrence is not.

The proposed method allows to reduce the treatment time and time of temporary disability of patients by 2.0-2.5 times, to prevent relapse and other complications.

The method provides bloodlessness, asepticity and low invasiveness of the operation, simultaneous elimination of fistulas and sterilization of the wound. A good cosmetic effect is achieved (gentle scar).

Claims (1)

The method of treatment of the epithelial coccygeal passage, including the expansion of the coccygeal passage, characterized in that, in order to shorten the treatment time, prevent relapse and reduce complications, the coccygeal passage is cut with a focused beam of a COa laser, the bottom of the course is cleaned and the changed ones are evaporated tissues of the cavity, pockets and fistulous passages with a defocused beam of a CO2 laser with a power density of 20-40 W mm2, the wound is left open for the entire healing time under an aseptic dressing ..