[Approach to the present state of proctology in Andalusia (Spain): results of a community survey].
OBJECTIVE
Proctology has acquired such complexity that it requires a specific qualification, as well as the creation of specialized groups. In Andalusia there are proctologists throughout the public health system. Measurement of the quality of the distinct processes is essential. The aim of the present study was to determine the resources available, as well as to identify the management of these patients, with a view to identifying areas requiring improvement.


METHODS
A descriptive, multicenter, cross sectional study of the current situation of proctology in general surgery services in 25 hospitals in Andalusia (20 public and 5 private) was performed. A survey was used to identify the general characteristics of the hospital, the tests available, and the treatments used.


RESULTS
A total of 65.38% of the hospitals have a coloproctology unit, while a drop-in outpatient clinic is available in only 38.46%. Manometry and anal endosonography are available in 50% and 58%, respectively. Treatment of hemorrhoids is predominantly hemorrhoidectomy (92.30%). Medical treatment and sphincterotomy are the most widely used treatments for anal fissure, and anal dilation is still performed in 30.76%. Seton is used in 92.30%, as well as fistulotomy (88.46%), to treat fistula. The most frequent treatment of sinus is en-bloc resection and primary closure (54.16%). Between 30% and 44% report little experience of pelvic floor disorders.


CONCLUSIONS
Although there is a willingness to achieve progress and reach an adequate scientific level, a multitude of obsolete practices should be corrected. Tools such as scientific evidence, information management and evaluation by means of comparison with standards should be diligently included in our clinical practice.
Unidad Clínica de Coloproctología, Hospital Juan Ramón Jiménez, Huelva, Spain. delaportilla@ya.com
Fernando
F
de la Portilla
Ricardo
R
Belda
Gonzalo
G
Gutiérrez
Alberto
A
de la Rosa
Manuel
M
Ruiz
María
M
Socas
D003107:Colorectal Surgery / Q000592:standards / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D012002:Rectal Diseases / Q000453:epidemiology / Q000601:surgery*; D013030:Spain; D011795:Surveys and Questionnaires