Tocchi Adriano, Mazzoni Gianluca, Miccini Michelangelo, Cassini Diletta, Bettelli Elia, Brozzetti Stefania
First Department of Surgery, Medical School, University of Rome La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy.
Int J Colorectal Dis. 2004 May;19(3):245-9. doi: 10.1007/s00384-003-0525-9. Epub 2003 Sep 9.
Initial experience with the posterior sphincterotomy for treating anal fissures was unsatisfactory, with a significant rate of recurrences and anal incontinence. This report describes the lateral approach to complete section of the internal sphincter.
Between 1997 and 2001 we surgically treated 164 patients for anal fissure. Preoperative and postoperative anal manometries were recorded. Postoperative course and early and long-term results were recorded.
No fissure failed to heal. Early complications included bleeding, hematoma, and pain. A transient, variable degree of incontinence occurred in 15 patients and persistent incontinence to flatus and soiling in 5. After total sphincterotomy no long-term complication was observed. Patient satisfaction was 96%.
Total subcutaneous, internal sphincterotomy is a safe, effective procedure for the treatment of chronic anal fissure.
最初采用后位括约肌切开术治疗肛裂的经验并不理想，复发率和肛门失禁率都很高。本报告描述了完全切断内括约肌的外侧入路方法。
1997年至2001年间，我们对164例肛裂患者进行了手术治疗。记录术前和术后的肛门测压结果。记录术后病程以及早期和长期疗效。
所有肛裂均愈合。早期并发症包括出血、血肿和疼痛。15例患者出现短暂的、程度不一的失禁，5例患者出现持续性排气及粪便失禁。完全括约肌切开术后未观察到长期并发症。患者满意度为96%。
完全皮下内括约肌切开术是治疗慢性肛裂的一种安全、有效的方法。
