Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2011
Lateral internal sphincterotomy for chronic idiopathic anal fissure: an alternative approach.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Bessa Samer Saad
Аннотация
BACKGROUND: An alternative approach to lateral internal sphincterotomy in the management of chronic anal fissure is presented and its potential advantages are described.
METHODS: Using the conventional diathermy, the internal sphincter along with its overlying anoderm is cut to the caudal border of the dentate line.
RESULTS: This prospective study included 350 patients. Twenty-six patients (7.4%) reported spotting of blood with defecation and 266 patients (76%) reported minimal perianal discharge. The cessation of the discharge and spotting of blood correlated with the complete healing of the sphincterotomy wound. Urine retention requiring temporary catheterization was encountered in 19 patients (5.4%). Neither abscesses nor fistulae were encountered. Cure was achieved in all patients. Neither recurrences nor permanent fecal incontinence were encountered throughout the study period.
CONCLUSION: The alternative approach is efficient and safe and may be added to the surgeon's armamentarium when attempting lateral internal sphincterotomy for chronic anal fissure.
METHODS: Using the conventional diathermy, the internal sphincter along with its overlying anoderm is cut to the caudal border of the dentate line.
RESULTS: This prospective study included 350 patients. Twenty-six patients (7.4%) reported spotting of blood with defecation and 266 patients (76%) reported minimal perianal discharge. The cessation of the discharge and spotting of blood correlated with the complete healing of the sphincterotomy wound. Urine retention requiring temporary catheterization was encountered in 19 patients (5.4%). Neither abscesses nor fistulae were encountered. Cure was achieved in all patients. Neither recurrences nor permanent fecal incontinence were encountered throughout the study period.
CONCLUSION: The alternative approach is efficient and safe and may be added to the surgeon's armamentarium when attempting lateral internal sphincterotomy for chronic anal fissure.