Segmental internal sphincterotomy--a new technique for treatment of chronic anal fissure.

Autor: Lasheen AE; General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. lasheenahmed@yahoo.com, Morsy MM, Fiad AA
Jazyk: angličtina
Zdroj: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2011 Dec; Vol. 15 (12), pp. 2271-4. Date of Electronic Publication: 2011 Sep 27.
DOI: 10.1007/s11605-011-1689-1
Abstrakt: 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.
Databáze: MEDLINE
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