Journal Article10.1002/BJS.1800760504
Sequelae of internal sphincterotomy for chronic fissure in ano.
Indru T. Khubchandani,J. F. Reed +1 more
327
TL;DR: No significant differences in satisfaction with the outcome or in deficits in continence were noted between groups undergoing lateral, bilateral or posterior midline sphincterotomy, and excision of the fissure was found to be unnecessary.
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Abstract: A total of 1355 patients underwent internal sphincterotomy for chronic fissure in ano between 1980 and 1985. Surgical data were obtained for 1102 patients, and 829 patients responded to a questionnaire. Of the 1057 for whom the time of healing was recorded, 1033 (97.7 per cent) healed by a mean time of 5.6 weeks. No significant differences in satisfaction with the outcome or in deficits in continence were noted between groups undergoing lateral, bilateral or posterior midline sphincterotomy. Excision of the fissure was found to be unnecessary. According to responses on the questionnaires, deficits in continence ranging from 'sometimes' to 'frequently' included lack of control of flatus (35.1 per cent), soiling of underclothing (22.0 per cent) and accidental bowel movements (5.3 per cent). A significantly higher proportion of patients who had accidental bowel movements were aged over 40 years.
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Anal fistula surgery. Factors associated with recurrence and incontinence.
TL;DR: Surgical treatment of fistula-in-ano is associated with a significant risk of recurrence and a high risk of impaired continence and degree of risk varies with identifiable factors.
493
A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure.
Giuseppe Brisinda,Giorgio Maria,Anna Rita Bentivoglio,Emanuele Cassetta,Daniele Gui,Alberto Albanese +5 more
TL;DR: Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinu toxin is the more effective nonsurgical treatment.
384
A randomised, prospective, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure.
TL;DR: Topical GTN provides rapid, sustained relief of pain in patients with anal fissure and over two-thirds of patients treated in this way avoided surgery which would otherwise have been required for healing.
358
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TL;DR: The most reliable and satisfactory operation at present available for this condition seems, therefore, to be lateral subcutaneous internal sphincterotomy.
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The treatment of chronic fissure-in-ano. A trial of methods.
TL;DR: In patients at St. Mark’s Hospital, posterior or posterolateral sphincterotomy through the base of the fissure has been the operation most usually employed.
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Sliding skin grafts in the treatment of anal fissures.
TL;DR: The basic principles of plastic surgery for sliding skin graft have been employed routinely in and about the anal canal andcision of a chronic fissure and covering of the defect with a sliding-flap broad-based skin graft offers the advantages of decreased postoperative pain.
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•Journal Article
Closed hemorrhoidectomy with local anesthesia.
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