Document Detail

Island advancement flaps in the management of anal fissures.
MedLine Citation:
PMID:  7795999     Owner:  NLM     Status:  MEDLINE    
The classic high-pressure fissure responds well to lateral internal sphincterotomy. The management of recurrent fissures and those that occur in patients with weak sphincters is open to debate. An island advancement flap technique used in 21 patients is described with the above criteria. Preoperative median resting anal pressure was 66 (range 43-90) cmH2O and median maximal squeeze pressure was 132 (range 76-193) cmH2O, values that were significantly lower than in controls and those with classic fissure. Endoanal ultrasonography in 15 of these patients showed defects in the anal sphincters. All flaps healed primarily with preservation of sensation. Perfect continence was maintained in all patients. Follow-up was for a median of 18 (range 2-28) months. There were no serious complications. All fissures healed with minimal postoperative discomfort. This procedure provides a useful alternative for symptomatic anal fissures, in which a sphincter-weakening procedure might jeopardize continence.
D C Nyam; R G Wilson; K J Stewart; R Farouk; D C Bartolo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  82     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-07-31     Completed Date:  1995-07-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  326-8     Citation Subset:  AIM; IM    
Department of Surgery, Royal Infirmary of Edinburgh, UK.
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MeSH Terms
Fissure in Ano / physiopathology,  surgery*
Follow-Up Studies
Middle Aged
Surgical Flaps / methods*
Treatment Outcome

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

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