Document Detail

Simple cutaneous advancement flap anoplasty for resistant chronic anal fissure: a prospective study.
MedLine Citation:
PMID:  19225835     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A proportion of patients with chronic anal fissure have persistent symptoms and pathology despite optimum conservative therapies. Lateral anal sphincterotomy, the standard surgical treatment, is associated with functional compromise in a minority of patients. Sphincter-sparing anoplasty has been advocated as an alternative procedure for those with "low pressure" sphincters. The aim of this study was to determine the efficacy of simple cutaneous advancement flap anoplasty (SCAFA) when applied to consecutive patients with chronic anal fissure irrespective of anal tone and the patient's gender. METHOD: This was a prospective outcome study of 51 consecutive patients treated with SCAFA over a 6.5-year period. RESULTS: Surgery was well tolerated. There were three (5.9%) early flap dehiscences, all of which were treated with repeat SCAFA, and one of those three patients remained symptomatic at 2 months. All fissures healed in the short term. Three other patients subsequently developed fissures at sites remote from the original pathology. Continence was unaffected by the procedure. CONCLUSIONS: Simple cutaneous advancement flap anoplasty should be considered as a first-line surgical treatment of chronic anal fissure, irrespective of patient gender and anal tone.
Pasquale Giordano; Gianpiero Gravante; Pietro Grondona; Boris Ruggiero; Theresa Porrett; Peter James Lunniss
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  33     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1058-63     Citation Subset:  IM    
Department of Surgery, Whipps Cross University Hospital, Whipps Cross Road, London E11 1NR, UK.
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MeSH Terms
Aged, 80 and over
Anal Canal / surgery
Chronic Disease
Digestive System Surgical Procedures / methods*
Fissure in Ano / surgery*
Middle Aged
Prospective Studies
Surgical Flaps*
Treatment Outcome
Wound Healing
Young Adult

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

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