Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2011
Segmental internal sphincterotomy--a new technique for treatment of chronic anal fissure.
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Lasheen Ahmed E, Morsy Mansour M, Fiad Alaa A
Аннотация
OBJECTIVE: Lateral internal sphincterotomy is an effective treatment for fissure in ano but carries a definite risk of incontinence. In trial to avoid this complication, segmental lateral internal sphincterotomy was used to treat chronic anal fissures.
DESIGN: The lateral internal sphincterotomy was done in two parts and at different planes.
SETTING: This study was conducted in the General Surgery Department, Zagazig University Hospital, Egypt.
PATIENTS: This study was undertaken on 50 patients (43 men and seven women, with mean age of 37.3 years) with chronic fissure in ano from January 2009 to December 2010.
INTERVENTIONS: Under general or local anesthesia, lateral internal sphincterotomy was done in two segments under direct vision. Preoperative and postoperative anal manometry study was recorded.
MAIN OUTCOME MEASURES: Postoperative course with early and long-term results were recorded. Mean follow-up was 18.5 months (ranging from 6 to 24 months).
RESULTS: In 31 patients, the technique was done under general anesthesia and the remainder under local anesthesia. The fissures and anal wounds were healed within 4 weeks. Pain was significantly reduced in all patients at day 1 postoperative. Early complications included mild hematoma and urine retention in one male patient (2%). No transient or any persistent degree of incontinence occurred in these patients group.
CONCLUSION: Segmental lateral internal sphincterotomy is a safe, easy, and effective procedure and not associated with risk of incontinence for the treatment of chronic anal fissure.
DESIGN: The lateral internal sphincterotomy was done in two parts and at different planes.
SETTING: This study was conducted in the General Surgery Department, Zagazig University Hospital, Egypt.
PATIENTS: This study was undertaken on 50 patients (43 men and seven women, with mean age of 37.3 years) with chronic fissure in ano from January 2009 to December 2010.
INTERVENTIONS: Under general or local anesthesia, lateral internal sphincterotomy was done in two segments under direct vision. Preoperative and postoperative anal manometry study was recorded.
MAIN OUTCOME MEASURES: Postoperative course with early and long-term results were recorded. Mean follow-up was 18.5 months (ranging from 6 to 24 months).
RESULTS: In 31 patients, the technique was done under general anesthesia and the remainder under local anesthesia. The fissures and anal wounds were healed within 4 weeks. Pain was significantly reduced in all patients at day 1 postoperative. Early complications included mild hematoma and urine retention in one male patient (2%). No transient or any persistent degree of incontinence occurred in these patients group.
CONCLUSION: Segmental lateral internal sphincterotomy is a safe, easy, and effective procedure and not associated with risk of incontinence for the treatment of chronic anal fissure.