93 results match your criteria Anal Surgery Fissurectomy


Management of chronic anal fissure: results of a national survey among gastrointestinal surgeons in the Netherlands.

Int J Colorectal Dis 2022 Apr 22;37(4):973-978. Epub 2022 Feb 22.

Department of Surgery, Proctos Clinic, Bilthoven, The Netherlands.

Background: Chronic anal fissure (CAF) is a common, bothersome condition frequently accompanied by pelvic floor complaints. Despite current guidelines, optimal management is challenging. The aim of this study is to evaluate current management of CAF among gastrointestinal surgeons in the Netherlands. Read More

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Scanner-Assisted CO Laser Fissurectomy: A Pilot Study.

Front Surg 2021 28;8:799607. Epub 2021 Dec 28.

SOSD Proctologia, USL Toscana Centro, Florence, Italy.

Surgery for chronic anal fissure is challenging for every proctologist. Solving the pain by guaranteeing rapid and effective healing is the objective, but what is the price to pay today in functional terms? Though this result is nowadays partially achievable through interventions that include the execution of an internal sphincterotomy among the procedures, it is necessary to underline the high rate of patients who can present faecal incontinence. The aim of this study is to explore the effectiveness of scanner-assisted CO laser fissurectomy. Read More

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December 2021

Lateral Internal sphincterotomy is still crucial to heal hypertonic chronic anal fissure and normalize the internal anal sphincter tone? Is V-en Y plastic a valuable alternative?

Ann Ital Chir 2021 ;92:554-559

Introduction: The role of augmented internal anal sphincter (IAS) tone in the genesis of chronic anal fissure (CAF) is still unclear. Lateral internal sphincterotomy (LIS) is the most employed surgical procedure, aiming to reduce the IAS tone leaving a permanent anatomical alteration and it is burdened by high risk post-operative anal incontinence (AI). The aim of this work was to evaluate if the pre-operative manometric alterations of CAFs with hypertonic IAS would normalize after sphincter preserving surgical procedure. Read More

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January 2022

Botulinum toxin associated with fissurectomy and anoplasty for hypertonic chronic anal fissure: A case-control study.

World J Clin Cases 2021 Nov;9(32):9722-9730

Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo 90100, Sicily, Italy.

Background: Lateral internal sphincterotomy is still the approach of choice for the treatment of chronic anal fissure (CAF) with internal anal sphincter (IAS) hypertonia, but it is burdened by high-risk postoperative faecal incontinence (FI). Sphincter saving procedures have recently been reconsidered as treatments to overcome this risk. The most employed procedure is fissurectomy with anoplasty, eventually associated with pharmacological sphincterotomy. Read More

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November 2021

Clinical Trial of Combining Botulinum Toxin Injection and Fissurectomy for Chronic Anal Fissure: A Dose-Dependent Study.

Ann Coloproctol 2021 Dec 3. Epub 2021 Dec 3.

Division of General Surgery, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Purpose: Our aim was to evaluate the effectiveness of combining a fissurectomy with a botulinum toxin A injection in treating chronic anal fissure.

Methods: A single surgeon in Saudi Arabia conducted a nonrandomized prospective cohort study between October 2015 and July 2020. The cohort included 116 female patients with chronic anal fissures with a mean age of 36. Read More

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December 2021

Results of surgical treatment in chronic anal fissure complicated by abscess or fistula in a retrospective cohort of patients.

Updates Surg 2022 Feb 27;74(1):179-183. Epub 2021 Nov 27.

General Surgery, Hospital Val Vibrata, Sant'omero, 64027, L'Aquila, TE, Italy.

We report the results of the surgical treatment of anal fissures complicated by abscess or fistula and formulate hypotheses about their nature. Among patients operated between 2012 and 2020 for anal fissure resistant to medical therapy, those affected by septic complications were selected for our inquiry. Surgical treatment consisted in the drainage of the sepsis, fissurectomy, posterior sphincterotomy and anoplasty. Read More

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February 2022

Fissurectomy and anoplasty in posterior normotensive chronic anal fissure.

Acta Biomed 2021 11 3;92(5):e2021176. Epub 2021 Nov 3.

University of Palermo.

Purpose: Anal Fissure (AF) is the second most frequent proctological disease in Italy. Chronic AF (CAF) most common located at the posterior anal commissure (CAPF). CAPF are thought to be associated with hypertonic internal anal sphincter (IAS) but manometric findings showed that a normotonic IAS is present in the 20-40%. Read More

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November 2021

Does Adding a Fissurectomy to Botox Sphincterotomy Increase Success Rate or Just Cost?

Am Surg 2021 Nov 3:31348211050830. Epub 2021 Nov 3.

Department of Surgery, 8586University of Kansas School of Medicine-Wichita, Wichita, KS, USA.

Background: While Botox sphincterotomy with or without fissurectomy has been proven effective in healing anal fissures, they have not been directly compared. We evaluated cost-effectiveness and outcomes between Botox sphincterotomies with and without fissurectomy.

Methods: A 5-year retrospective review was conducted comparing all patients undergoing Botox sphincterotomy for anal fissure with or without fissurectomy. Read More

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November 2021

Injection of botulinum toxin significantly increases efficiency of fissurectomy in the treatment of chronic anal fissures.

Int J Colorectal Dis 2022 Feb 2;37(2):309-312. Epub 2021 Nov 2.

Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium.

Purpose: While acute anal fissures can be treated with topical therapy to reduce sphincter hypertonia (e.g., isosorbide dinitrate, glyceryl trinitrate, diltiazem), chronic fissures may require more invasive instrumental therapy. Read More

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February 2022

Fissurectomy Versus Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissure: A Randomized Control Trial.

Cureus 2021 Sep 28;13(9):e18363. Epub 2021 Sep 28.

Surgery, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, IND.

Introduction An anal fissure is defined as a longitudinal split in the distal anoderm which extends from the anal verge to the dentate line. Fissures can be of primary or secondary type. The posterior midline is the most common location for primary fissures, while, anterior primary fissures, though rare, are more common in females. Read More

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September 2021

Treatment of anal fissures: Results from a national survey on French practice.

Clin Res Hepatol Gastroenterol 2022 04 16;46(4):101821. Epub 2021 Oct 16.

Clinique Saint Antoine, Nice, France.

Background: Treatment of an anal fissure (AF) is based on medical treatment (nonoperative therapies) and surgical procedures. However, the choice of treatment and its role in therapeutic strategy vary from one country to another, and to date, no standard French recommendation is currently available. Our aim was to assess French practices in the treatment of AFs. Read More

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Safety and effectiveness of saving sphincter procedure in the treatment of chronic anal fissure in female patients.

BMC Surg 2021 Sep 24;21(1):350. Epub 2021 Sep 24.

General Surgery Unit, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via Liborio Giuffrè, 5, 90127, Palermo, Italy.

Introduction: Lateral internal sphincterotomy (LIS) is still the approach of choice for the treatment of chronic anal fissure (CAF) regardless to the internal anal sphincter tone but it is burdened by high risk post-operative faecal incontinence (FI). In female patient there are some anatomical and functional differences of the sphinteric system which make them more at risk of FI and vaginal birth could cause sphinteric lesions affecting the anal continence function. The aim of our study is to evaluate the results of saving sphincter procedure as treatment for female patients affected by CAF. Read More

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September 2021

Anocutaneous advancement flap provides a quicker cure than fissurectomy in surgical treatment for chronic anal fissure-a retrospective, observational study.

Langenbecks Arch Surg 2021 Dec 22;406(8):2861-2867. Epub 2021 Jun 22.

Centrum Coloproctologie, Klinik Maingau Vom Roten Kreuz, Eschenheimer Anlage 7, 60316, Frankfurt am Main, Germany.

Purpose: Anocutaneous advancement flap is a surgical procedure for the treatment of chronic anal fissures. This study aimed to assess the results of anocutaneous advancement flap in a consecutive cohort of patients.

Methods: This is a retrospective, observational study. Read More

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December 2021

Use of Botulinum Toxin Injections for the Treatment of Chronic Anal Fissure: Results From an American Society of Colon and Rectal Surgeons Survey.

Am Surg 2021 Jun 7:31348211023446. Epub 2021 Jun 7.

Division of Colon and Rectal Surgery, 21886Advocate Lutheran General Hospital, Park Ridge, IL, USA.

Background: Chronic anal fissure (CAF) is commonly treated by colorectal surgeons. Pharmacological treatment is considered first-line therapy. An alternative treatment modality is chemical sphincterotomy with injection of botulinum toxin (BT). Read More

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Management of recurrent chronic anal fissure after lateral internal sphincterotomy.

Asian J Surg 2021 Jun 28;44(6):932-933. Epub 2021 May 28.

General Surgery Unit, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Italy; Postgraduate Medical School in General Surgery, University of Palermo, Palermo, Italy.

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Reliability of digital rectal examination as compared to anal manometry in chronic anal fissure.

Asian J Surg 2021 Jul 26;44(7):1021-1022. Epub 2021 May 26.

General Surgery Unit - Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Italy.

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Long term outcomes of fissurectomy and anoplasty for chronic anterior anal fissure without hypertonia: low recurrences and continence conservation.

Ann Ital Chir 2020 Dec 21;9. Epub 2020 Dec 21.

Introduction: Aetiopathogenesis of Chronic Anal Anterior Fissure (CAAF) remains poorly understood. Some anatomical, clinical and functional features suggest that pathophysiology may be linked to a reduced anal canal pressure. LIS appear illogical as a treatment for CAAF and the employ of techniques aiming to save the integrity of the sphincterial system appears more sensible. Read More

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December 2020

Surgical Sphincter Saving Approach and Topical Nifedipine for Chronic Anal Fissure with Hypertonic Internal Anal Sphincter.

Chirurgia (Bucur) 2020 Sept-Oct;115(5):585-594

Purpose: The role of augmented internal anal sphincter (IAS) tone in the genesis of posterior chronic anal fissure (CAPF) is still unknown. Lateral internal sphincterotomy is the most employed surgical procedure, nevertheless it is burdened by high risk post-operative anal incontinence. The aim of our study is to evaluate results of sphincter saving procedure with post-operative pharmacological sphincterotomy for patients affected by CAPF with IAS hypertonia. Read More

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December 2020

Fisurectomy and anoplasty with botulinum toxin injection in patients with chronic anal posterior fissure with hypertonia: a long-term evaluation.

Updates Surg 2021 Aug 14;73(4):1575-1581. Epub 2020 Jul 14.

General Surgery Unit, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via Liborio Giuffrè, 5, 90127, Palermo, Italy.

Chronic anal fissure's (CAF) etiopathogenesis remain unclear. CAF of the posterior commissure (CAPF) are often characterized by internal anal sphincter (IAS) hypertonia. The treatment of this disease aimed to reduce IAS hypertonia. Read More

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[Anal fissure].

Rev Prat 2019 Nov;69(9):1005-1010

Service de proctologie médico-chirurgicale, groupe hospitalier Paris-Saint-Joseph, Paris, France.

Anal fissure. Anal fissure is a painful proctological disease that most often affects young patients equally in both sexes. It significantly worsens the quality of life and requires rapid care. Read More

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November 2019

Fissurectomy with vertical non-full-thickness sphincterotomy for chronic anal fissure.

Tech Coloproctol 2019 Oct 24;23(10):1009-1013. Epub 2019 Sep 24.

Department of Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa City, Chiba, 296-8602, Japan.

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October 2019

Anoplasty with skin tag flap for the treatment of chronic anal fissure.

Rev Col Bras Cir 2019 Aug 15;46(3):e20192181. Epub 2019 Aug 15.

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Cirurgia do Aparelho Digestivo e Coloproctologia, São Paulo, SP, Brasil.

Objective: 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.

Methods: 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. Read More

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Treatment of a chronic anal fissure with a botulin toxin A injection and fissurectomy.

Rev Esp Enferm Dig 2019 Sep;111(9):672-676

Servicio de Cirugía General y Aparato Digestivo, Hospital de Jove, España.

Introduction: pharmacological treatment of a chronic anal fissure (CAF) achieves healing in half of cases and lateral internal sphincterotomy (LIS) is the definite treatment. The objective of this study was to assess the combination of fissurectomy and botulin toxin A (BTA) injection.

Methods: this was a retrospective study of 54 patients with anal sphincter hypertonia and CAF treated with an injection of BAT and fissurectomy, after an unsuccessful management with topical nitroglycerin (NGT) for eight weeks. Read More

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September 2019

[Chronic anal fissure: etiopathogenesis, diagnosis, treatment].

Khirurgiia (Mosk) 2018(11):89-95

Municipal Clinical Hospital #24 of Moscow Healthcare Department, Moscow, Russia.

Etiology, epidemiology and pathophysiology of anal fissure are examined in the article in order to determine the most optimal treatment strategy. The authors concluded that the most effective treatment is combined approach using both minimally invasive surgery and various medicines for anal spasm reduction. Read More

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Long-term Outcome of a Fissurectomy: A Prospective Single-Arm Study of 50 Operations out of 349 Initial Patients.

Ann Coloproctol 2018 Apr 30;34(2):83-87. Epub 2018 Apr 30.

Proctologie Médico-Chirurgicale, Institut Léopold Bellan, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Purpose: The surgical standard of care for patients with chronic anal fissure is still disputed. We aimed to assess the natural course of idiopathic anal fissure and the long-term outcome of a fissurectomy as a surgical treatment.

Methods: All consecutive patients referred to a single expert practitioner in a tertiary centre were primarily included. Read More

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Operative and medical treatment of chronic anal fissures-a review and network meta-analysis of randomized controlled trials.

J Gastroenterol 2017 Jun 10;52(6):663-676. Epub 2017 Apr 10.

Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland.

Anal fissures are a common problem and have a cumulative lifetime incidence of 11%. Previous reviews on anal fissures show inconsistent results regarding post-interventional healing and incontinence rates. In this review our aim was to compare the treatments for chronic anal fissures by incorporating indirect comparisons using network meta-analysis. Read More

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Fissurectomy Combined with High-Dose Botulinum Toxin Is a Safe and Effective Treatment for Chronic Anal Fissure and a Promising Alternative to Surgical Sphincterotomy.

Dis Colon Rectum 2015 Oct;58(10):967-73

Warrington Hospital, Warrington, Merseyside, United Kingdom.

Background: There is paucity of data on the long-term outcome of the combination of fissurectomy and botulinum toxin A injection for the management of chronic anal fissure.

Objectives: The aim of this study is to assess the safety, efficacy, and long-term outcome of the combination of fissurectomy and botulinum toxin A injection.

Design: This is a nonrandomized prospective cohort study. Read More

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October 2015

Prospective Single-Center Observational Study of Routine Histopathologic Evaluation of Macroscopically Normal Hemorrhoidectomy and Fissurectomy Specimens in Search of Anal Intraepithelial Neoplasia.

Dis Colon Rectum 2015 Jul;58(7):692-7

1 Service de Proctologie Médico-Interventionnelle, Groupe Hospitalier Diaconesses Croix-Saint-Simon, Paris, France 2 Service d'Anatomie et de Cytologie pathologiques, Hôpital Saint-Antoine, Paris, France.

Background: The necessity for routine histopathologic evaluation of hemorrhoidectomy specimens considered free of suspicious areas after careful visual and manual inspection remains controversial.

Objective: The purpose of this work was to prospectively study the prevalence of anal intraepithelial neoplasia in macroscopically normal operative specimens.

Design And Patients: From October 2005 to September 2010, all hemorrhoidectomy and fissurectomy specimens were sent for routine histopathologic analysis. Read More

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[Management of complications of fissure and fistula surgery].

Authors:
Andreas Ommer

Chirurg 2015 Aug;86(8):734-40

Kompetenzzentrum für Koloproktologie, End- und Dickdarm-Zentrum Essen, Rüttenscheiderstr. 66, 45130, Essen, Deutschland,

Background: Fistula-in-ano and anal fissures are common proctological diseases. In most cases of anal fissures conservative treatment provides good clinical results, whereas for fistula-in-ano operative treatment is the only option.

Objective: The most important and for the patient most stressful long-term complication is postoperative incontinence, especially as the deliberate severance of the anal sphincter musculature is part of the treatment for many patients. Read More

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