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Introduction: We live in a society with a growing number of diabetics. That is why the number of diabetic patients with peripheral arterial disease is expanding, as is the number of cases of chronic ischemia, which threatens limb viability, or chronic limb-threatening ischemia (CLTI). The appearance of diabetic foot ulcers with an ischemic component represents the maximum risk of amputation in the absence of a firm and rapid revascularization intervention. In our study, we aim at early detection of patients who need infusion treatment immediately after surgical revascularization. Material and methods: This is a six-year retrospective study of 115 patients with infrainguinal occlusive disease and CLTI. All subjects were classified according to the WIfI system before and after revascularization. We made a score based on the postoperative clinical evolution in the first three days in order to have an objective image of patients who received infusion treatment with PG E1. Results: All patients included in our study had diabetes. They were divided into two groups, one comprising 86 patients who underwent exclusively surgical treatment, and the other comprising 29 patients, who received a combined surgical and medical treatment. We showed that subjects who had a low postoperative score and received infusion treatment had a higher rate of limb rescue in the first year. Conclusions: In diabetic patients with infrainguinal occlusive disease who were treated in the Clinic, without the possibility of endovascular or hybrid interventions, the combination of infusion treatment with PG E1 after surgical revascularization led to a higher rate of limb rescue and healing of ischemic trophic lesions after one year. [ABSTRACT FROM AUTHOR]

Cryptoglandular complex perianal fistulas represent a suppurative chronic process of the anoperianal region which involves anal sphincter and perianal spaces. High number of relapses and risk of postoperative anal incontinence lead to the numerous methods of surgical techniques, the most widely used being „sphincter saving" technique. In this context we believe that thorough preoperative evaluation by clinical examination, endoanorectal ultrasound or pelvic MRI, and anal manometry in selected cases, represent an algorithm that will lead to the identification and selection of surgical techniques which will allow us to obtain the best postoperative results. [ABSTRACT FROM AUTHOR]

Complex perianal fistulas constitute a section of the surgical pathology which has not been assigned a standardized therapeutical approach, as none of the known surgical techniques is able to simultaneously prevent anal incontinence, as well as any relapses that may occur. The surgical procedures which are usually employed tend to focus on the preservation of the anal sphincter, thus improving the general quality of life. Taking into account the aforementioned factors, we believe that the endoanorectal mucosal advancement flap leads to superior results, a conclusion which is supported by the small number of relapses, as well as a lack of sphincterian damage. We hereby present the case of a complex high „Y“ shape transphincterian perianal fistula in a 54-years-old man who underwent a fistulectomy with endoanorectal mucosal advancement flap. Anal continence was documented by pre and postoperative anal sphincterian manometry; the healing process was concluded after one year. [ABSTRACT FROM AUTHOR]