In 1860, the Department of hospital surgery was organized at Imperial Kazan university. The reform of medical education to Western standards supposed the training of students in faculty and hospital clinics. The main task of the faculty Department is to teach the classical clinical picture of the most common diseases, while the task of the hospital Department is focusing to variants of clinical manifestations of the disease and improvement of practical skills. The first head of the Department of hospital surgery at Imperial Kazan University was Professor Andrey Beketov. Professor A.N. Beketov is one of the pioneers of the use of inhalation anesthesia, which he recommended for widespread use in the clinic. Besides, Beketov is the author of priority works in the field of traumatology and orthopedics. In a short time, the hospital surgical clinic in Kazan became one of the leading clinics in the East of Russia, the Urals and Siberia.

Aim. To determine the efficacy of brand new industrial synthetic material for surgical treatment of patients with complicated anal fistulae and advantages of its use for ligature method of chronic paraproctitis treatment. Methods. Between 2010 and 2017, 175 patients (average age 47 years) with extra- and transsphincteric fistula were treated with a ligature. The study group consisted of 67 patients treated with rubber seton, comparison group included 108 patients treated with nylon ligature. Results. The results of clinical use of two seton types for the treatment of rectal fistulae are presented. Rubber thread with circular section as seton was proved to be inexpensive and effective material, advantages of which result from its physical properties. Thus, dissection of muscle tissue due to rubber elasticity becomes more efficient due to the greater reserve of compression than in case of rigid nylon seton, and that reduces the number of contractions. In addition, physical properties of the material, such as its high surface wettability, offer good drainage, and homogeneity of the material not absorbing the fluids, in turn, provides avoidance of the «wick effect» with the spread of infection into the wound. So, the treatment of anorectal fistulae with ligature with the use of rubber seton demonstrates the best therapeutic results and is preferable for patients. Conclusion. Use of rubber seton in treatment of complicated anal fistulae allows reducing hospital stay, provides better drainage of the surgical wound, and reducing the number of complications and required contractions, thus, minimizing the associated pain syndrome.