The aim of this study was to assess the efficacy of fissurectomy with skin advancement flap in healing chronic anal fissures without hypertonia of the internal anal sphincter. Twenty-six consecutive patients who failed healing after well-practiced topical medical therapy were enrolled. Anorectal manometry was performed preoperative and 6 months postoperatively. All patients were treated with fissurectomy and advancement flap through healthy skin tissue. All patients healed completely within 30 days from operation. The intensity and the duration of pain postdefecation was reduced significantly with respect to the preoperative values starting from the first defecation. One patient suffered urinary retention, two patients suffered infections, and two partial breakdowns were recorded. At 6 months the maximum resting pressure values were similar to those were detected preoperatively. One month after surgery, anal incontinence was reported in seven patients, four of whom complained about it preoperatively. At 12 months, only three subjects reported incontinence. No patients needed reoperation and no recurrences were detected. The fissurectomy, in combination with advancement flap, is a safe sphincter-saving procedure for the treatment of chronic anal fissures without hypertonia of internal anal sphincter that fails medical conservative treatment.

Patti, R., Famà, F., Tornambè, A., Restivo, M., Di Vita, G.G. (2010). Early results of fissurectomy and advancement flap for resistant chronic anal fissure without hypertonia of the internal anal sphincter. THE AMERICAN SURGEON, 76(2), 206-210.

Early results of fissurectomy and advancement flap for resistant chronic anal fissure without hypertonia of the internal anal sphincter

PATTI, Rosalia;TORNAMBE', Antonino;RESTIVO, Margherita;DI VITA, Gaetano Giuseppe
2010-01-01

Abstract

The aim of this study was to assess the efficacy of fissurectomy with skin advancement flap in healing chronic anal fissures without hypertonia of the internal anal sphincter. Twenty-six consecutive patients who failed healing after well-practiced topical medical therapy were enrolled. Anorectal manometry was performed preoperative and 6 months postoperatively. All patients were treated with fissurectomy and advancement flap through healthy skin tissue. All patients healed completely within 30 days from operation. The intensity and the duration of pain postdefecation was reduced significantly with respect to the preoperative values starting from the first defecation. One patient suffered urinary retention, two patients suffered infections, and two partial breakdowns were recorded. At 6 months the maximum resting pressure values were similar to those were detected preoperatively. One month after surgery, anal incontinence was reported in seven patients, four of whom complained about it preoperatively. At 12 months, only three subjects reported incontinence. No patients needed reoperation and no recurrences were detected. The fissurectomy, in combination with advancement flap, is a safe sphincter-saving procedure for the treatment of chronic anal fissures without hypertonia of internal anal sphincter that fails medical conservative treatment.
2010
Settore MED/18 - Chirurgia Generale
Patti, R., Famà, F., Tornambè, A., Restivo, M., Di Vita, G.G. (2010). Early results of fissurectomy and advancement flap for resistant chronic anal fissure without hypertonia of the internal anal sphincter. THE AMERICAN SURGEON, 76(2), 206-210.
File in questo prodotto:
File Dimensione Formato  
american surgeon.pdf

accesso aperto

Dimensione 77.11 kB
Formato Adobe PDF
77.11 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/197620
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 22
  • ???jsp.display-item.citation.isi??? 16
social impact