AI Article Synopsis
- Lateral internal sphincterotomy is effective for anal fissures but can lead to postoperative incontinence.
- A study compared three treatment methods: conventional sphincterotomy, V-Y advancement flap, and a combination of both.
- Results showed that the combined approach had the highest healing rate (94%) and the lowest incontinence rate (2%), suggesting it's the best option for patients with chronic anal fissures.
Article Abstract
Background: Lateral internal sphincterotomy has been proven highly effective in curing anal fissure but with a high incidence of postoperative incontinence.
Objective: We compared conventional lateral internal sphincterotomy, V-Y advancement flap, and combined tailored lateral internal sphincterotomy with V-Y advancement flap in treating anal fissure.
Patients: Consecutive patients treated for anal fissure at our colorectal unit were evaluated for inclusion. Participants were randomly allocated to receive conventional sphincterotomy (GI), V-Y advancement flap (GII), or combined tailored lateral sphincterotomy with V-Y advancement l flap (GIII).
Main Outcome Measures: The primary outcome measure was the incontinence rate; secondary outcomes included healing rate, operative time, anal manometery, and recurrence rate.
Results: One hundred fifty patients with chronic anal fissure were randomized. Healing rate after 1 year was 84% in GI, 48% in GII, and 94% in GIII, respectively (P = 0.001). The recurrence rate was 4% in G1, 22% in GII, and 2% in GIII (P = 0.01). Incontinence rate was 14% in GI, 0% in GII, and 2% in GIII (P = 0.03).
Conclusion: Although all three procedures are simple and easy to perform, tailored lateral internal sphincterotomy with V-YF appears to produce the greatest healing rate, with the fewest complications and less rate of recurrence.
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| http://dx.doi.org/10.1007/s11605-012-1984-5 | DOI Listing |
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