Six-month follow up of fissurectomy with or without anoplasty for chronic anal fissure: low recurrence rate and no effect on continence

Alaa El Din Mohammed, Asem Mohamed, Wael Ahmed, Mostafa Mohammed
2018 Sohag Medical Journal  
Introduction The management of CAF at a time shifted from surgical to medical treatment; chemical sphincterotomy through nitric oxide (NO) donors, calcium-channel blockers or botulinum toxin combined with stool softeners and life-style changes. In resistant CAF, the surgical choice is necessary. Lateral internal sphincterotomy (LIS) has long been the gold standard. Its early results have been favourable, but there is concern over continence in the long term after LIS. Fissurectomy with or
more » ... t anoplasty, described in our study is an alternative with no or minimal effect on anal continence. Aim of the work: This study purpose is to assess the safety and short-term outcome results of fissurectomy with or without anoplasty (simple cutaneous advancement flap) as a sphincter saving surgical technique in chronic anal fissure (CAF) and to compare between both procedures regarding post-operative patient's satisfaction, complications and wound healing. Method: Thirty-Seven series of patients (18 females), who had undergone fissurectomy with anal dilatation alone (14 patients) or combined with anoplasty (23 patients) for a medically resistant CAF, who were admitted at Sohag university hospitals from July 2016 were included in the study. At a duration of follow-up of 6 months, regular outpatient clinic visits for all patients; assessing postoperative pain (on visual analogue scale), wound healing, recurrence, satisfaction with the operation and faecal continence (on Pescatori score).
doi:10.21608/smj.2018.40788 fatcat:r4miok4rtbapdobp4iedpbkaay