Anoplasty with skin tag flap for the treatment of chronic anal fissure.

Autor:	Sobrado Júnior CW; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil., Hora JAB; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil., Sobrado LF; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil., Guzela VR; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil., Nahas SC; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil., Cecconello I; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil.
Jazyk:	Portuguese; English
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2019 Aug 15; Vol. 46 (3), pp. e20192181. Date of Electronic Publication: 2019 Aug 15.
DOI:	10.1590/0100-6991e-20192181
Abstrakt:	Objective: to evaluate the long-term results of the correction of chronic anal fissures (CAF) in patients without anal hypertonia using the technique of anoplasty with skin tag flap. Methods: we conducted a prospective study of CAF patients refractory to conservative treatment without anal hypertonia, subjected to anoplasty with the use of anal plicoma to cover the bloody area. We confirmed the absence of anal hypertonia through rectal exam and electromanometry. We applied a visual pain questionnaire and the Cleveland Clinic fecal incontinence score before and after surgery. Results: we followed 15 patients with chronic anal fissure for a mean period of 29 months (12-56). The mean age was 41 years (29-69) and the duration of symptoms ranged from six months to five years. Healing occurred between three and six weeks for 13 patients (86.7%). The other two patients underwent debridement and new anoplasty successfully. No plicoma necrosis or anal stenosis occurred in any patient. The anal incontinence score did not change after the procedure, and all patients reported reduced pain. After 12 months of follow-up, none of the patients presented recurrence or anal incontinence, and 93.3% (14/15) of the patients were very satisfied. Conclusion: fissurectomy and anoplasty with the use of sentinel plie is a safe technique that results in improvement in pain without change of fecal continence and with high satisfaction rates.
Databáze:	MEDLINE
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