Long term outcomes of lateral internal sphincterotomy for the treatment of anal fissure. Coloproctology Division of Surgical Clinic 2, Maciel Hospital
Resultados alejados de la esfinterotomía interna lateral en el tratamiento de la fisura anal. Unidad de Coloproctología de la Clínica Quirúrgica 2 del Hospital Maciel
Resumen:
Background: Sternal lateral sphincterotomy is the treatment of choice for anal fissure when medical treatment fails. It has a high success rate but as a counterpart can present up to 10% variable degrees of incontinence: Objective: To evaluate the results of lateral lateral sphincterotomy in a series of patients with anal fissure. Materials and methods: Twenty patients with anal fissure were evaluated in whom a lateral internal sphincterotomy was performed at one year. The evaluation was done by personal or telephone interview. Two aspects were fundamentally analyzed: relapse of the symptomatology and sphincter function. Results: all patients were discharged within 24 hours postoperatively with low levels of postoperative pain, controlled with oral analgesics. Ten days postoperatively they did not present major complications or intense anal pain in any case. No recurrences of the anal fissure were found at one year after the patients were monitored. Fecal continence levels were perfect in 17 patients (Wexner score 0) and in 3 patients (15%) incontinence was detected for gases and exceptionally for liquid substances (score 5) Discussion: Internal lateral sphincterotomy remains a safe option for the treatment of anal fissure, with high levels of cure and low sequelae in sphincter function, mainly affecting gas continence
Antecedentes:La esfinterotomía interna lateral es el tratamiento de elección de la fisura anal cuando fracasa el tratamiento médico. Tiene una elevada tasa de éxito pero como contrapartida puede presentar hasta en un 10 % grados variables de incontinencia Objetivo: Evaluar los resultados alejados de la esfinterotomía interna lateral en una serie de pacientes operados por fisura anal. Materiales y métodos: Se evaluaron 20 pacientes portadores de fisura anal en quienes se realizó una esfinterotomía interna lateral al año de la misma. La evaluación fue realizada mediante entrevista personal o telefónica. Se analizó fundamentalmente dos aspectos: recidiva de la sintomatología y función esfinteriana. Resultados: La totalidad de los pacientes fueron dados de alta dentro de las 24 horas del postoperatorio con niveles bajos de dolor postoperatorio, controlado con analgésicos orales. A los diez días del postoperatorio no presentaron complicaciones mayores ni dolor anal intenso en ningún caso. Al año de controlados no se constataron recidivas de la fisura anal. Los niveles de continencia fecal fueron perfectos en 17 pacientes (score de Wexner 0) y en tres pacientes (15%) se constató incontinencia para gases y excepcionalmente para materias líquidas (score 5) Discusión: La esfinterotomía interna lateral sigue siendo una opción segura para el tratamiento de la fisura anal, con niveles altos de curación y bajos de secuelas en la función esfinteriana, afectando principalmente la continencia para gases.
2019 | |
esfinterotomía interna lateral incontinencia recidiva lateral internal sphincterotomy incontinence relapse |
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Español | |
Sociedad de Cirugía del Uruguay | |
Revista Cirugía del Uruguay | |
https://revista.scu.org.uy/index.php/cir_urug/article/view/19 | |
Acceso abierto |
Sumario: | Background: Sternal lateral sphincterotomy is the treatment of choice for anal fissure when medical treatment fails. It has a high success rate but as a counterpart can present up to 10% variable degrees of incontinence: Objective: To evaluate the results of lateral lateral sphincterotomy in a series of patients with anal fissure. Materials and methods: Twenty patients with anal fissure were evaluated in whom a lateral internal sphincterotomy was performed at one year. The evaluation was done by personal or telephone interview. Two aspects were fundamentally analyzed: relapse of the symptomatology and sphincter function. Results: all patients were discharged within 24 hours postoperatively with low levels of postoperative pain, controlled with oral analgesics. Ten days postoperatively they did not present major complications or intense anal pain in any case. No recurrences of the anal fissure were found at one year after the patients were monitored. Fecal continence levels were perfect in 17 patients (Wexner score 0) and in 3 patients (15%) incontinence was detected for gases and exceptionally for liquid substances (score 5) Discussion: Internal lateral sphincterotomy remains a safe option for the treatment of anal fissure, with high levels of cure and low sequelae in sphincter function, mainly affecting gas continence |
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