Fischer M, Thermann M, Trobisch M, Sturm R, Hamelmann H
Langenbecks Arch Chir. 1976 Dec 22;343(1):35-44. doi: 10.1007/BF01261568.
A double-blind, randomized, controlled trial in the treatment of primary chronic fissure-in-ano by digital stretching of the anal canal or by a modified lateral subcutaneous sphincterotomy is reported. Whereas there was no difference in the postoperative course of both groups, by checking 65 of 66 patients 6 months postoperatively, we found significantly more lacks of continence after stretching. There was no difference regarding recurrence rate. Pressure monitoring of the anal canal showed significantly higher values at rest in both groups before operation. No correlation between results of monitoring anal pressure and defects of anal continence has been seen. These results point out that in treatment of primary chronic fissure-in-ano the lateral subcutaneous sphincterotomy is superior to anal dilatation regarding postoperative defects of anal continence. The recurrence rate in the present study does not force to prefer one of these two methods. Manometric investigations show that the resting pressure in anal canal seems to be elevated in primary chronic fissure-in-ano.
报告了一项关于通过肛管指扩或改良的外侧皮下括约肌切开术治疗原发性慢性肛裂的双盲、随机对照试验。虽然两组术后病程无差异，但术后6个月对66例患者中的65例进行检查时，我们发现指扩后大便失禁的情况明显更多。复发率方面没有差异。肛管压力监测显示两组术前静息值均显著更高。未发现肛管压力监测结果与肛门失禁缺陷之间存在相关性。这些结果表明，在原发性慢性肛裂的治疗中，就术后肛门失禁缺陷而言，外侧皮下括约肌切开术优于肛门扩张术。本研究中的复发率并未表明需要优先选择这两种方法中的一种。测压研究表明，原发性慢性肛裂患者肛管静息压力似乎升高。
