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Comparative Study of Conventional Lateral Internal Sphincterotomy, V-Y Anoplasty, and Tailored Lateral Internal Sphincterotomy with V-Y Anoplasty in the Treatment of Chronic Anal Fissure.
MedLine Citation:
PMID:  22869534     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Lateral internal sphincterotomy has been proven highly effective in curing anal fissure but with a high incidence of postoperative incontinence. OBJECTIVE: We compared conventional lateral internal sphincterotomy, V-Y advancement flap, and combined tailored lateral internal sphincterotomy with V-Y advancement flap in treating anal fissure. PATIENTS: Consecutive patients treated for anal fissure at our colorectal unit were evaluated for inclusion. Participants were randomly allocated to receive conventional sphincterotomy (GI), V-Y advancement flap (GII), or combined tailored lateral sphincterotomy with V-Y advancement l flap (GIII). MAIN OUTCOME MEASURES: The primary outcome measure was the incontinence rate; secondary outcomes included healing rate, operative time, anal manometery, and recurrence rate. RESULTS: One hundred fifty patients with chronic anal fissure were randomized. Healing rate after 1 year was 84 % in GI, 48 % in GII, and 94 % in GIII, respectively (P = 0.001). The recurrence rate was 4 % in G1, 22 % in GII, and 2 % in GIII (P = 0.01). Incontinence rate was 14 % in GI, 0 % in GII, and 2 % in GIII (P = 0.03). CONCLUSION: Although all three procedures are simple and easy to perform, tailored lateral internal sphincterotomy with V-YF appears to produce the greatest healing rate, with the fewest complications and less rate of recurrence.
Authors:
Alaa Magdy; Ayman El Nakeeb; El Yamani Fouda; Mohamed Youssef; Mohamed Farid
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-7
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  -     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Mansoura University Hospital, Mansoura, Egypt.
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