Metoda chirurgicznego wycięcia kłykcin kończystych odbytu skojarzonego z elektrokoagulacją w materiale Oddziału Proktologii Szpitala na Solcu w Warszawie

Anna Kosim¹, *Małgorzata Kołodziejczak¹, Iwona Sudoł-Szopińska²

Streszczenie
Treatment of condylomata acuminata is difficult and unrewarding because of the recurrence of the ailment and most often, large area of the affected skin.
Aim: The objective of the study was to assess the effectiveness of the treatment of anal canal and perineal area condylomata acuminata by surgical excision combined with electrocoagulation.
Material and methods: The material: in the years 2000-2007 there were operated, due to anal canal and anal area condylomata acuminata, 67 patients (46 men and 21 women) in the age from 20 to 81 (med. 39 years) in Warsaw Śródmiejski Hospital, Proctology Unit. Among them 13 had confirmed HIV virus infection. Large condylomata (Buschke-Loewenstein tumour) were found in 8 patients.
The method: the method of the treatment was surgical excision combined with electrocoagulation. In one case, there was artificial anus created, because of inoperbility of the Buschke-Loewenstein tuomur.
Results: recurrent condylomata were found in 10 cases. All cases of recurrence affected men. Six men were operated twice, two male patients were operated three times. In one case the patient was disqualified from local excision and because of Buschke-Loewenstein tumour had an artificial anus preformed. All patients after large condylomata excision went through a long period of healing: from 8 weeks to about 3 months, in three of them healing was not obtained. Two patients with Buschke-Loewenstein tumour had histopathology result – carcinoma planoepitheliale. These patiens were sent to further consultation and treatment to the reference center – the Institute of Oncology.
Conclusions: 1. surgical excision combined with electrocoagulation is an effective method of anal canal and anal area codylomata acuminata treatment. 2. large condylomata are treated effectively by this method only in 50% of cases, as well as time of healing is long (in 3 cases healing was not obtained, one patient had an artificial anus performed). Problem of treating large condylomata remains still unsolved. It should be approached by multidisciplinary groups of experts (surgeon, dermatologist, gynaecologist, oncologist).

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