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2000, Number 2

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Cir Gen 2000; 22 (2)

Surgical treatment for anorectal pathology in HIV positive homosexual patients

Navarrete CT, Obregón CL, Parraguirre MS, Vick FR

Language: Spanish
References: 31
Page: 115-120
PDF size: 112.22 Kb.


ABSTRACT

Objective: To know the most frequent anorectal pathologies in HIV-infected patients and to determine the usefulness of surgery in this group of patients.
Setting: Third level health care hospital.
Methods: We analyzed the clinical records of HIV+ patients with anorectal pathologies and subjected to surgical treatment between March 1995 and March 1997. We reviewed the surgical indication, HIV/AIDS stage, association with microorganisms, and therapeutic success.
Results: There were 20 male patients, with 4.2 years of seropositivity, subjected to 28 surgical procedures. Diagnoses: eight anal sinuses, seven condylomas, six fistulas, five anal fissures, and two anal ulcers. The performed procedures were: one sphincterotomy, two biopsies, four fissurectomies, six fistulotomies, seven fulgurations and exeresis of condylomas, and eight unroofings of the anal sinus. Histopathological studies revealed association to microorganisms in 85% of the cases, severe dysplasla in 15%, and malignant neoplasia in 10%. Post-operative follow-up (average of 9 months) yielded an excellent surgical result in 15 patients (they remained asymptomatic), good in three (symptomatic with improvement) and bad in two (without any improvement). No relation was found between the postoperative morbidity and the HIV/AIDS stage.
Conclusion: Anorectal surgery in HIV positive patients can be performed safely, without important postoperative complications. It must be performed in time to improve the quality of life of this group of patients.


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