Jensen S L, Lund F, Nielsen O V, Tange G
Br Med J (Clin Res Ed). 1984 Sep 1;289(6444):528-30. doi: 10.1136/bmj.289.6444.528.
Fifty eight patients with idiopathic chronic anal fissure were included in a randomised prospective trial of lateral subcutaneous sphincterotomy versus simple anal dilatation carried out as outpatient procedures. Operations were performed under local anaesthesia and the patients reviewed 10-30 months later (median follow up time 18 months). Altogether 30 patients were treated by lateral subcutaneous sphincterotomy and 28 by anal dilatation. No serious complications were observed in either group. One recurrence was observed in the group treated by sphincterotomy, whereas eight occurred in the other group (p less than 0.05). Functional results with respect to impaired control of flatus and soiling of underwear were significantly better after sphincterotomy (p less than 0.002). It is concluded that lateral subcutaneous sphincterotomy is the treatment of choice for idiopathic chronic anal fissure resistant to conservative measures.
58例特发性慢性肛裂患者被纳入一项前瞻性随机试验，该试验比较了门诊进行的外侧皮下括约肌切开术与单纯扩肛术。手术在局部麻醉下进行，术后10至30个月（中位随访时间18个月）对患者进行复查。共有30例患者接受了外侧皮下括约肌切开术，28例接受了扩肛术。两组均未观察到严重并发症。括约肌切开术组观察到1例复发，而另一组有8例复发（p<0.05）。括约肌切开术后，在排气控制受损和内裤污染方面的功能结果明显更好（p<0.002）。结论是，外侧皮下括约肌切开术是对保守治疗无效的特发性慢性肛裂的首选治疗方法。
