Abstract
to evaluate the long-term results of the correction of chronic anal fissures (CAF) in patients without anal hypertonia using the technique of anoplasty with skin tag flap. we conducted a prospective study of CAF patients refractory to conservative treatment without anal hypertonia, subjected to anoplasty with the use of anal plicoma to cover the bloody area. We confirmed the absence of anal hypertonia through rectal exam and electromanometry. We applied a visual pain questionnaire and the Cleveland Clinic fecal incontinence score before and after surgery. we followed 15 patients with chronic anal fissure for a mean period of 29 months (12-56). The mean age was 41 years (29-69) and the duration of symptoms ranged from six months to five years. Healing occurred between three and six weeks for 13 patients (86.7%). The other two patients underwent debridement and new anoplasty successfully. No plicoma necrosis or anal stenosis occurred in any patient. The anal incontinence score did not change after the procedure, and all patients reported reduced pain. After 12 months of follow-up, none of the patients presented recurrence or anal incontinence, and 93.3% (14/15) of the patients were very satisfied. fissurectomy and anoplasty with the use of sentinel plie is a safe technique that results in improvement in pain without change of fecal continence and with high satisfaction rates.
Highlights
Anal fissure is an extremely painful condition that has as a first line treatment pharmacological agents that cause muscle relaxation and improvement in local microcirculation[1]
A systematic review by Cochrane published by Nelson, in 2005, with randomized trials evaluating fecal incontinence after sphincterotomy revealed an average risk of 10%7
We used an anoplasty technique with the use of skin tag flap for the treatment of chronic anal fissure and we evaluated the results of 15 patients submitted to surgical treatment
Summary
Anal fissure is an extremely painful condition that has as a first line treatment pharmacological agents that cause muscle relaxation and improvement in local microcirculation[1]. The gold standard surgical technique is anal lateral internal sphincterotomy (LIS), which results in healing in 90% to 100% of cases Despite these high success rates, continence disorders have been reported in up to 43% of cases[3,4,5,6]. The presence of post-sphincterotomy fecal incontinence may be permanent or persist for long periods, causing worsening of quality of life, regardless of age or gender. For this reason, a series of procedures with preservation of anal sphincters has been attempted in patients with refractory anal fissure
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
