Mucosal Advancement Flap Anoplasty for Chronic Anal Fissure Resistant to Conservative Therapy

Abstract

Mucosal advancement flap anoplasty might be another sphincter-sparing treatment option in patients suffering from CAF. To draw final conclusions about the value of MAAP in the treatment of CAF, more solid data are required.

Systematic review of the use of topical diltiazem compared with glyceryltrinitrate for the nonoperative management of chronic anal fissure

“…Chronic anal fissure (CAF) is common and affects all age groups with an equal incidence in both genders [1]. Surgery, including lateral internal sphincterotomy, anal stretch, posterior sphincterotomy, fissurectomy, dermal advancement flap and autologous fat transplantation, is potentially associated with risk of a transient continence disturbance [2][3][4][5][6][7][8][9][10]. Pharmacological agents, such as glyceryltrinitrate (GTN), diltiazem (DTZ) and botulinum injection, can be successful treatments but they have a significant recurrence rate [11][12][13][14][15].…”

Advancement flap in the management of chronic anal fissure: a prospective study

“…Few recent studies [4,[23][24][25][26][27][28] To cover the exposed area after fissurectomy, an advancement skin graft has been mostly used. Only recently, a mucosal advancement flap has been used [29,30]. The rationale of advancing flaps of skin and fat is based on introducing fresh blood supply to the ischaemic area of the fissure [2], reducing the time required for perianal wound healing and avoiding the risk of anal stenosis that follows healing by scarring [16].…”

Anal Incontinence as a Complication of Vaginal Delivery and Anorectal Surgery

“…The proportion developing postoperative incontinence when using this technique ranges from 0-16% [23,24]. The surgical treatment of chronic or recurring fissures may involve techniques based on mucosal advancement flap anoplasty, anal advancement flap or anodermal flap [25,26].…”