DEVELOPMENT AND EVALUATION OF A DIAGNOSTIC AND TREATMENT ALGORITHM FOR SELECTING THE OPTIMAL SURGICAL TREATMENT FOR CHRONIC PARAPROCTITIS IN PATIENTS WITH DIABETES MELLITUS
Abstract
Background: Chronic paraproctitis (CP) in patients with diabetes mellitus (DM) presents a significant clinical challenge due to high recurrence rates and impaired tissue healing. Methods: This study involved 119 patients divided into a control group (n=58, traditional treatment) and an academic group (n=61, algorithm-based treatment). A diagnostic and treatment algorithm was developed based on the "VRCP" (Probability of Recurrence of Chronic Paraproctitis) integral prognostic scale, utilizing laser Doppler flowmetry (LDF) and cytological indices. Results: The implementation of the algorithm led to a reduction in recurrence rates from 31% to 6.6%. Healing times were significantly shortened, and the average treatment cost decreased from 5.0 million UZS to 3.7 million UZS. Conclusion: The integrated approach using laser and plasma technologies guided by the VRCP scale ensures superior clinical and economic outcomes for diabetic patients with CP.