Anal fissure surgery: Difference between revisions
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===Surgical Sphincterotomy=== | ===Surgical Sphincterotomy=== | ||
Surgical intervention may be required for persisting deep anal fissures unresponsive to the above conservative measures. Procedures include: | Surgical intervention may be required for persisting deep anal fissures unresponsive to the above conservative measures. Procedures include: | ||
* | *Lateral internal sphincterotomy or [[excision|excising]] a portion of the sphincter | ||
* Anal dilation or stretching of the anal canal is no longer recommended because of the unacceptably high incidence of [[fecal incontinence]].<ref>{{cite journal |author=Kotlarewsky M, Freeman JB, Cameron W, Grimard LJ |title=Anal intraepithelial dysplasia and squamous carcinoma in immunosuppressed patients |journal=Canadian journal of surgery. Journal canadien de chirurgie |volume=44 |issue=6 |pages=450-4 |year=2001 |pmid=11764880 |doi= |url=http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/cjs/vol-44/issue-6/pdf/pg450.pdf |format=PDF}}</ref> In addition, anal stretching can increase the rate of flatus incontinence.<ref>{{cite journal |author=Sadovsky R |title=Diagnosis and management of patients with anal fissures - Tips from Other Journals |journal=American Family Physician |year=2003 |month=1 April |volume=67 | issue=7 |pages=1608 |url=http://findarticles.com/p/articles/mi_m3225/is_7_67/ai_99410474 |format=Reprint}}</ref> | * Anal dilation or stretching of the anal canal is no longer recommended because of the unacceptably high incidence of [[fecal incontinence]].<ref>{{cite journal |author=Kotlarewsky M, Freeman JB, Cameron W, Grimard LJ |title=Anal intraepithelial dysplasia and squamous carcinoma in immunosuppressed patients |journal=Canadian journal of surgery. Journal canadien de chirurgie |volume=44 |issue=6 |pages=450-4 |year=2001 |pmid=11764880 |doi= |url=http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/cjs/vol-44/issue-6/pdf/pg450.pdf |format=PDF}}</ref> In addition, anal stretching can increase the rate of flatus incontinence.<ref>{{cite journal |author=Sadovsky R |title=Diagnosis and management of patients with anal fissures - Tips from Other Journals |journal=American Family Physician |year=2003 |month=1 April |volume=67 | issue=7 |pages=1608 |url=http://findarticles.com/p/articles/mi_m3225/is_7_67/ai_99410474 |format=Reprint}}</ref> | ||
Revision as of 15:19, 30 January 2018
Anal fissure Microchapters |
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Anal fissure surgery On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Overview
Indications
- Surgery is usually the mainstay of treatment and done for patients with either:
- Not responding to conservative measures
- Chronic anal fissures
Surgery
Surgical Sphincterotomy
Surgical intervention may be required for persisting deep anal fissures unresponsive to the above conservative measures. Procedures include:
- Lateral internal sphincterotomy or excising a portion of the sphincter
- Anal dilation or stretching of the anal canal is no longer recommended because of the unacceptably high incidence of fecal incontinence.[1] In addition, anal stretching can increase the rate of flatus incontinence.[2]
Despite the high success rate of these surgical procedures (~95%), there are potential side effects, which include risks from anesthesia, infection, and anal leakage (fecal incontinence).
References
- ↑ Kotlarewsky M, Freeman JB, Cameron W, Grimard LJ (2001). "Anal intraepithelial dysplasia and squamous carcinoma in immunosuppressed patients" (PDF). Canadian journal of surgery. Journal canadien de chirurgie. 44 (6): 450–4. PMID 11764880.
- ↑ Sadovsky R (2003). "Diagnosis and management of patients with anal fissures - Tips from Other Journals" (Reprint). American Family Physician. 67 (7): 1608. Unknown parameter
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