Document Detail

Fissurectomy and anal advancement flap for anterior chronic anal fissure without hypertonia of the internal anal sphincter in females.
MedLine Citation:
PMID:  19843117     Owner:  NLM     Status:  MEDLINE    
AIM: Lateral internal sphincterotomy is considered the surgical treatment of choice for chronic anal fissure after failure of medical therapy but it risks continence. The aim of the study was to evaluate fissurectomy with advancement flap for anterior chronic anal fissure (CAAF) resistant to medical therapy.
METHOD: Sixteen women with CAAF without hypertonia of the internal anal sphincter, unresponsive to previous medical treatment, were included in the study. Absence of hypertonia was defined as a maximum anal resting pressure (MRP) of less than 85 mmHg. All patients underwent fissurectomy with an advancement skin flap.
RESULTS: Complete healing occurred in all patients within 30 days. The intensity and the duration of pain after defecation reduced from the first postoperative defecation. MRP before surgery and at 6 months showed no significant difference. At 1 month, four patients experienced a continence disturbance, two of whom had it preoperatively. At 12 months, two (12.5%) patients continued to experience a continence disturbance.
CONCLUSION: Fissurectomy with skin advancement flap resulted in complete healing and full relief of symptoms in all patients. There was a low incidence of continence disturbance.
R Patti; F Famà; T Barrera; G Migliore; G Di Vita
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  12     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-14     Completed Date:  2011-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1127-30     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.
Division of General Surgery, Department of Surgical and Oncological Science, University of Palermo, Palermo, Italy.
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MeSH Terms
Anal Canal / physiopathology
Chronic Disease
Digestive System Surgical Procedures / methods*
Fissure in Ano / surgery*
Middle Aged
Muscle Hypertonia / physiopathology
Prospective Studies
Surgical Flaps*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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