Document Detail


A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure.
MedLine Citation:
PMID:  19415396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We compare lateral internal sphincterotomy as an effective treatment of chronic fissure in ano to fissurectomy, which is as an alternative surgical treatment. METHODS: Sixty two consecutive patients were divided into two groups through sequential sampling. Thirty patients underwent fissurectomy and 32 underwent lateral internal sphincterotomy. After a median follow-up of 22 months, we compared the results of the two procedures. In addition to frequent visits on a predetermined basis, a telephone inquiry into fissure recurrence and continence status was made. RESULTS: All patients in both groups were pain-free and without bleeding within 1 week. In both groups, urinary retention was noted in one patient. Incontinence to flatus was noted in the fissurectomy (F) group in two (6.2%) patients, but no incontinence was noted in the lateral internal sphincterotomy (LIS) group. There was one patient (3.1%) with fissure recurrence in the F group but none in the LIS group. No patient in either group was afflicted with anal stenosis or perianal infections. All wounds healed within 8 weeks. Twenty nine patients (96.6%) in the LIS group and 28 (87.5%) in the F group reported satisfactory results with their procedure. CONCLUSION: In the surgical treatment of chronic anal fissure not responding to conservative management, LIS may be the better treatment and, perhaps, the preferable surgical technique with fewer total complications (P < 0.005).
Authors:
S R Mousavi; M Sharifi; Zohreh Mehdikhah
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-05-05
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-09     Completed Date:  2009-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-82     Citation Subset:  IM    
Affiliation:
Shohada Hospital, Shahid Beheshti University of Medical Sciences and Health Services, Tajrish square, Tehran, Iran. seyed29@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / surgery*
Chi-Square Distribution
Chronic Disease
Digestive System Surgical Procedures / methods*
Fecal Incontinence / prevention & control
Female
Fissure in Ano / diagnosis,  surgery*
Follow-Up Studies
Humans
Male
Middle Aged
Patient Satisfaction
Postoperative Complications / physiopathology
Probability
Quality of Life*
Recurrence
Risk Assessment
Severity of Illness Index
Surgical Procedures, Minimally Invasive / methods
Treatment Outcome
Wound Healing / physiology
Young Adult

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


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