The presence of post-sphincterotomy fecal incontinence may be permanent or persist for long periods, causing worsening of quality of life, regardless of age or gender. Cochrane Database Syst Rev 2005 Apr 18:CD002199. A systematic review by Cochrane published by Nelson, in 2005, with randomized trials evaluating fecal incontinence after sphincterotomy revealed an average risk of 10% 7 7 Nelson R. Incontinence after a lateral internal sphincterotomy: are we underestimating it? Dis Colon Rectum. 6 6 Casillas S, Hull TL, Zutshi M, Trzcinski R, Bast JF, Xu M. Quality of life assessment in patients with chronic anal fissure after lateral internal sphincterotomy. Long-term results of lateral internal sphincterotomy in patients with chronic anal fissure with particular reference to incidence of fecal incontinence. Despite these high success rates, continence disorders have been reported in up to 43% of cases 3 3 Nyam DC, Pemberton JH. In cases of failure, the gold standard surgical technique is anal lateral internal sphincterotomy (LIS), which results in healing in 90% to 100% of cases. ![]() Concepts in pathogenesis and treatment of chronic anal fissure-a review of the literature. Treatment by chemical sphincterotomy is a simple method, with cure rates between 30% to 96% 2 2 Utzig MJ, Kroesen AJ, Buhr HJ. Fissure-in-ano, to divide or not to divide? Acta Chir Belg. Conclusão:įissurectomia e anoplastia com o uso do plicoma sentinela é uma técnica segura que resulta em melhora da dor sem alterações da continência fecal e com altas taxas de satisfação.įissura Anal/terapia Doenças Retais Qualidade de Vida Canal Anal Retalhos CirúrgicosĪnal fissure is an extremely painful condition that has as a first line treatment pharmacological agents that cause muscle relaxation and improvement in local microcirculation 1 1 Brugman T, Bruyninx L, Jaquet NJ. Após 12 meses de seguimento, nenhum paciente apresentou recorrência ou incontinência anal e 93,3% (14/15) dos pacientes responderam estar muito satisfeitos. O escore de incontinência anal não se alterou após o procedimento e todos os pacientes referiram melhora da dor. ![]() Em nenhum paciente ocorreu necrose do plicoma ou estenose anal. Os outros dois pacientes foram submetidos a desbridamento e nova anoplastia, com sucesso. A cicatrização ocorreu entre três e seis semanas para 13 pacientes (86,7%). A média de idade foi 41 anos (29 a 69) e a duração dos sintomas variou entre seis meses e cinco anos. Quinze pacientes com fissura anal crônica foram acompanhados por um período médio de 29 meses (12 a 56). Foi aplicado um questionário de dor visual e o escore de incontinência fecal da Cleveland Clinic, antes e após a cirurgia. Foi confirmada a ausência de hipertonia anal através do toque retal e da eletromanometria. Métodos:Įstudo prospectivo de pacientes com fissura anal crônica refratários ao tratamento conservador e sem hipertonia anal, submetidos à operação de anoplastia com utilização do plicoma anal para cobrir a área cruenta. Conclusion:įissurectomy and anoplasty with the use of sentinel plie is a safe technique that results in improvement in pain without change of fecal continence and with high satisfaction rates.įissure in Ano/therapy Rectal Diseases Quality of Life Anal Canal Surgical FlapsĪvaliar os resultados de longo prazo da correção de fissuras anais crônicas em pacientes sem hipertonia anal usando a técnica de anoplastia com o plicoma sentinela. After 12 months of follow-up, none of the patients presented recurrence or anal incontinence, and 93.3% (14/15) of the patients were very satisfied. The anal incontinence score did not change after the procedure, and all patients reported reduced pain. No plicoma necrosis or anal stenosis occurred in any patient. The other two patients underwent debridement and new anoplasty successfully. ![]() Healing occurred between three and six weeks for 13 patients (86.7%). The mean age was 41 years (29-69) and the duration of symptoms ranged from six months to five years. We followed 15 patients with chronic anal fissure for a mean period of 29 months (12-56). ![]() We applied a visual pain questionnaire and the Cleveland Clinic fecal incontinence score before and after surgery. We confirmed the absence of anal hypertonia through rectal exam and electromanometry. 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. 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.
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