Sphincter‐sparing anal‐fissure surgery: a 1‐year prospective, observational, multicentre study of fissurectomy with anoplasty

Abramowitz, Laurent; Bouchard, D.; Souffran, Marc-Henry; Devulder, Franck; Ganansia, Roland; Castinel, A.; Jm, Suduca; Soudan, D.; Varastet, Marina; Staumont, G.; d’Hépato‐Gastroentérologie, Cregg: Club de Réflexion des cabinets et Groupe

doi:10.1111/j.1463-1318.2012.03176.x

Cited by 45 publications

(21 citation statements)

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“…Anal fissures usually manifest suddenly, with intense anal pain triggered by defaecation, and may be accompanied by anal bleeding and itching. Most patients recover spontaneously or after medical or surgical treatment , but relapses are frequent. Despite the frequency of anal fissures, there are no severity rating scales.…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of a questionnaire (HEMO‐FISS‐QoL) to evaluate the burden associated with haemorrhoidal disease and anal fissures

Abramowitz

Bouchard²,

Siproudhis

et al. 2018

Colorectal Disease

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Section: Introductionmentioning

confidence: 99%

Psychometric properties of a questionnaire (HEMO‐FISS‐QoL) to evaluate the burden associated with haemorrhoidal disease and anal fissures

Abramowitz

Bouchard²,

Siproudhis

et al. 2018

Colorectal Disease

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“…Therefore, alternative techniques have been proposed, but are considered as being associated with a lower level of evidence. Among those techniques are the ’tailored’ lateral sphincterotomy [ 5 ], pneumatic balloon dilation [ 6 ], and foremost surgical techniques that do not divide the internal anal sphincter, namely, a subcutaneous fissurotomy [ 7 ], fissurectomy [ 8 , 9 ] and fissurectomy associated with anoplasty, the so-called V-Y cutaneous flap [ 10 ] or mucosal flap [ 9 , 11 ]. Many authors initially offered those techniques to patients with high risk of postoperative incontinence, such as elderly people, multiparous women, patients with normal anal tone, patients with chronic diarrhea of any origin, and patients who had undergone previous anorectal surgery.…”

Section: Introductionmentioning

confidence: 99%

Long-term Outcome of a Fissurectomy: A Prospective Single-Arm Study of 50 Operations out of 349 Initial Patients

et al. 2018

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Purpose The surgical standard of care for patients with chronic anal fissure is still disputed. We aimed to assess the natural course of idiopathic anal fissure and the long-term outcome of a fissurectomy as a surgical treatment.Methods All consecutive patients referred to a single expert practitioner in a tertiary centre were primarily included. A fissurectomy was proposed in cases of refractory symptoms after 4 to 6 weeks of standard medical management. Only patients with idiopathic and noninfected anal fissures were included in this second subsample to undergo surgery. Conventional postoperative management was prescribed for all patients who had undergone surgery. The main outcome measures were the success rate (defined as a combination of wound healing and relief of pain) and postoperative anal continence.Results Three hundred forty-nine patients were primarily recruited. Fifty patients finally underwent surgery for an idiopathic and noninfected fissure. Among them, 47 (94%) were cured at the end of primary follow-up, and 44 of the 47 (93.6%) could be confirmed as being sustainably cured in the longer-term follow-up. The mean time of complete healing was 10.3 weeks (range, 5.7–36.4 weeks). All patients were free of pain at weeks 42. The continence score after surgery was not statistically different from the preoperative score.Conclusion A fissurectomy for the treatment of patients with an idiopathic noninfected fissure is associated with rapid pain relief and a high success rate even though complete healing may often be delayed. Moreover, it appears to have no adverse effect on continence.

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“…Le risque d'incontinence anale concernait les patients à risque : anté-cédents de cholécystectomie, de multiparité et de déchirure périnéale. Le degré de satisfaction était de 91 % [39]. L'efficacité de la fissurectomie semble se maintenir au long cours avec 11,6 % de récidive après un suivi moyen de 8,2 ans [5,5 à 12,2] et un impact sur la continence fécale minime [40].…”

Section: La Fissurectomieunclassified

Mise au point sur la prise en charge des fissures anales

Higuero¹

2015

Journal de Chirurgie Viscérale

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Sphincter‐sparing anal‐fissure surgery: a 1‐year prospective, observational, multicentre study of fissurectomy with anoplasty

Abstract: Given its high rate of healing and low rate of de-novo anal incontinence, fissurectomy with anoplasty is a valuable sphincter-sparing surgical treatment for chronic anal fissure.

Cited by 45 publications

References 37 publications

Psychometric properties of a questionnaire (HEMO‐FISS‐QoL) to evaluate the burden associated with haemorrhoidal disease and anal fissures

Psychometric properties of a questionnaire (HEMO‐FISS‐QoL) to evaluate the burden associated with haemorrhoidal disease and anal fissures

Long-term Outcome of a Fissurectomy: A Prospective Single-Arm Study of 50 Operations out of 349 Initial Patients

Mise au point sur la prise en charge des fissures anales

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