77 results match your criteria Anal Surgery Fissurectomy


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 2020 Jul 14. 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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Combined approach in the treatment of chronic anal fissures.

Updates Surg 2015 Mar 21;67(1):83-9. Epub 2015 Apr 21.

Department of Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,

This study was designed to evaluate the healing and complications rates in surgically and conservatively treated patients with chronic anal fissure. Conservative treatment consisted of nitrate or diltiazem ointment. In case of surgery, fissurectomy was performed. Read More

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Dermal flap advancement combined with conservative sphincterotomy in the treatment of chronic anal fissure.

Am Surg 2015 Feb;81(2):133-42

Colorectal and Inflammatory Bowel Diseases Unit, First Department of Propaedeutic Surgery of Athens Medical School, Athens, Greece.

Lateral internal sphincterotomy (LIS) is considered the surgical treatment of choice for chronic anal fissure (CAF). Flap techniques for fissure coverage have the advantage of primary wound healing, potentially providing better functional results and faster pain relief. The standard surgical strategy for CAF consisting of conventional LIS (CLIS) up to the dentate line was modified by "tailoring" the LIS to the apex of the CAF, but never greater than 1 cm, and by advancing a dermal flap for coverage of the CAF (LIS + flap) after fissurectomy. Read More

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February 2015

Update on the management of anal fissure.

Authors:
T Higuero

J Visc Surg 2015 Apr 8;152(2 Suppl):S37-43. Epub 2014 Oct 8.

11, boulevard du Général-Leclerc, 06240 Beausoleil, France. Electronic address:

Anal fissure is an ulceration of the anoderm in the anal canal. Its pathogenesis is due to multiple factors: mechanical trauma, sphincter spasm, and ischemia. Treatment must address these causative factors. Read More

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Sphincter-Preserving Therapy for Treating a Chronic Anal Fissure: Long-term Outcomes.

Authors:
Ridzuan Farouk

Ann Coloproctol 2014 Jun 23;30(3):132-4. Epub 2014 Jun 23.

Department of Surgery, National University Hospital, Singapore.

Purpose: To estimate the risk of recurrent fissure in ano after sphincter preserving treatments.

Methods: A retrospective case note review, combined with a telephone survey was conducted for all patients treated for a chronic anal fissure between 1998 and 2008.

Results: Six hundred and twelve patients (303 women: mean age, 39 years; range, 16-86 years) were treated for chronic anal fissure between 1998 and 2008. Read More

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The efficacy and morbidity of different surgical treatment techniques for chronic anal fissure: an academic colorectal experience.

Am Surg 2014 Mar;80(3):241-4

Greenville Hospital System, University Medical Center, Greenville, South Carolina, USA.

Up to 40 per cent of chronic fissures will fail to heal with medical treatment alone. Open (OLIS) and closed (CLIS) lateral internal sphincterotomies are considered by many to be the treatment of choice for chronic anal fissures (CAF). The aim of this study was to compare the efficacy and clinical outcomes of different surgical techniques for treatment of CAF. Read More

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Anal stretch plus fissurectomy for chronic anal fissure.

Authors:
A Cariati

Acta Chir Belg 2013 Sep-Oct;113(5):322-4

General Surgery, San Martino, IST Hospital, Genoa, Italy.

Introduction: Anal fissure is a common disease. Usually chronic anal fissures are managed medically. When conservative management fails, surgical treatment should be considered. Read More

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January 2014

Medical and surgical treatment of haemorrhoids and anal fissure in Crohn's disease: a critical appraisal.

BMC Gastroenterol 2013 Mar 11;13:47. Epub 2013 Mar 11.

Department of Surgery, University Hospital Tor Vergata, Viale Oxford 81, Rome 00133, Italy.

Background: The principle to avoid surgery for haemorrhoids and/or anal fissure in Crohn's disease (CD) patients is still currently valid despite advances in medical and surgical treatments. In this study we report our prospectively recorded data on medical and surgical treatment of haemorrhoids and anal fissures in CD patients over a period of 8 years.

Methods: Clinical data of patients affected by perianal disease were routinely and prospectively inserted in a database between October 2003 and October 2011 at the Department of Surgery, Tor Vergata University Hospital, Rome. Read More

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Comparative study of glyceryl trinitrate ointment versus surgical management of chronic anal fissure.

Indian J Surg 2011 Aug 8;73(4):268-77. Epub 2011 May 8.

Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 (D.K.) Karnataka India.

Chronic Anal Fissure (CAF) is common perineal condition and well-known painful entity. Standard surgical treatment even though available, may require long hospital stay and sometimes have worrying complications like anal incontinence. So non-surgical treatment, Glyceryl Trinitrate has been shown to be an effective for chronic anal fissure. Read More

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Sphincter-sparing anal-fissure surgery: a 1-year prospective, observational, multicentre study of fissurectomy with anoplasty.

Colorectal Dis 2013 Mar;15(3):359-67

Unité de Proctologie Médico-Chirurgicale, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France.

Aim: Internal sphincterotomy is the standard surgical treatment for chronic anal fissure, but is frequently complicated by anal incontinence. Fissurectomy is proposed as an alternative technique to avoid sphincter injury. We describe 1-year outcomes of fissurectomy. Read More

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Value of cytologic Papanicolaou smears and polymerase chain reaction screening for human papillomavirus DNA in detecting anal intraepithelial neoplasia: comparison with histology of a surgical sample.

Cancer 2012 Dec 6;118(24):6031-8. Epub 2012 Jun 6.

Proctology Service-Medical Intervention, Diaconesses-Croix St Simon Group Hospitals, Paris, France.

Background: The performance of cytologic screening and its correlation with histology and polymerase chain reaction (PCR) detection of human papillomavirus (HPV) DNA have not been evaluated in populations with a low prevalence of anal intraepithelial neoplasia (AIN). The objective of the current study was to analyze the significance of abnormal smears relative to the histology and PCR detection of HPV DNA.

Methods: A cytologic smear and a viral sample were taken in 300 consecutive patients undergoing surgery (Milligan-Morgan hemorrhoidectomy and/or fissurectomy) who gave their informed consent. Read More

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December 2012

Manometric evaluation of internal anal sphincter after fissurectomy and anoplasty for chronic anal fissure: a prospective study.

Am Surg 2012 May;78(5):523-7

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

Chronic anal fissure (CAF) is a common painful clinical disease and its pathogenesis remains poorly understood. After failure of pharmacological therapy, that is the first-line treatment, surgical sphincterotomy remains the treatment of choice although it is followed by a high rate of anal incontinence resulting from the sphincter damage; therefore, the research of a sphincter-saving surgical option has become an important goal. The aim of this study was to evaluate the manometric modifications and the incidence of anal incontinence after fissurectomy and anoplasty with advancement skin flap in patients affected by CAF with hypertonia of the internal anal sphincter (IAS). Read More

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Advancement flap in the management of chronic anal fissure: a prospective study.

Updates Surg 2012 Jun 10;64(2):101-6. Epub 2012 Apr 10.

Department of Surgical and Oncologic Science, University of Palermo, Palermo, Italy.

Lateral internal sphincterotomy is the surgical treatment of choice of chronic anal fissure after failure of conservative measures. Several randomized trials identified an overall risk of incontinence of 10 % mostly for flatus. Fissurectomy is the most commonly used procedure to preserve the integrity of the anal sphincters. Read More

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Operative procedures for fissure in ano.

Cochrane Database Syst Rev 2011 Nov 9(11):CD002199. Epub 2011 Nov 9.

Department of General Surgery, Northern General Hospital, Sheffield, UK.

Background: Reports of direct comparisons between operative techniques for anal fissure are variable in their results. These reports are either subject to selection bias (in non-randomized studies) or observer bias (in all studies) or have inadequate numbers of patients enrolled to answer the question of efficacy.

Objectives: To determine the best technique for fissure surgery. Read More

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November 2011

Five-year results of fissurectomy for chronic anal fissure: low recurrence rate and minimal effect on continence.

Colorectal Dis 2012 Aug;14(8):997-1000

Department of Colorectal Surgery, Zaans Medical Centre, Zaandam, The Netherlands.

Aim: The aim of the study was to determine the long-term outcome, recurrence rate and faecal incontinence score after fissurectomy for chronic anal fissure (CAF) not responding to conservative treatment.

Method: Fifty-three consecutive patients (29 women) who underwent fissurectomy for a medically resistant CAF between 1998 and 2005 were included in the study. At a minimum follow-up of 5 years a standardized questionnaire was sent to all patients, assessing recurrence, satisfaction with the operation (on a scale of 0-10) and faecal continence (Vaizey score, 0-24). Read More

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Identifying the best therapy for chronic anal fissure.

World J Gastrointest Pharmacol Ther 2011 Apr;2(2):9-16

Mariusz H Madalinski, NHS Lothian-University Hospitals Division, Edinburgh EH4 2XU, United Kingdom.

Chronic anal fissure (CAF) is a painful tear or crack which occurs in the anoderm. The optimal algorithm of therapy for CAF is still debated. Lateral internal sphincterotomy (LIS) is a surgical treatment, considered as the 'gold standard' therapy for CAF. Read More

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Medium-term results of anal advancement flap compared with lateral sphincterotomy for the treatment of anal fissure.

Int J Colorectal Dis 2011 Sep 12;26(9):1211-4. Epub 2011 May 12.

Southend General Hospital, Prittlewell Chase, Westcliff-on-Sea, SS0 0RY, Essex, UK.

Introduction: Anal fissure is associated with anal pain and bleeding. Lateral internal sphincterotomy (LIS) has been a common form of surgical management. This can however cause incontinence and hence an equally effective alternative without this risk would be ideal. Read More

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September 2011