The Long-term Effect of Standardized Anal Dilatation for Chronic Anal Fissure on Anal Continence

Czeiger, David; Lichtman, Daria; Reshef, A

doi:10.3393/ac.2020.03.16

Cited by 12 publications

(6 citation statements)

References 28 publications

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“…Both the techniques have been found to result is quick pain relief and high ulcer healing rate. Hartikainen [4] Pandit [6] reported that there was no significant age difference between the two groups as regard age and sex, Yucel [8] found no significant difference between gender and the age distributions of the patient and Pinsk [9] also showed that there were no significantly different between the groups as regard age and sex. Kiyak [5] showed that there were 68 (52.7%) female and 61 (47.3%) male patients.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Fissurectomy and Lateral Sphincterotomy Versus Fissurectomy and Anal Dilatation in Management of Chronic anal Fissure

2022

Al-Azhar University Journal of Virus Researches and Studies

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An anal fissure is a tear in the anoderm distal to the dentate line and can be acute or chronic. Acute fissures are those that have been present less than 2 to 3 months and heal with local management. Chronic anal fissures, due to scarring and poor blood flow, often require surgical intervention due to failed conservative management. Most commonly, anal fissures occur in the posterior midline; however, in up to 25% of women and 8% of men, a fissure can be located in the anterior midline. Comparative study to obtain the best method for treatment of chronic anal fissure by comparison outcome of lateral sphincterotomy and fissurectomy with sustained digital anal dilation. This study included 100 patients admitted in general surgery department of AL-Zahraa university hospital. Demographic data was recorded to all patients including age, sex. Position of fissure. Pre-operative symptoms and signs mainly pain, bleeding. constipation, discharge and pruritis ani Laboratory investigations was done for all patients mainly PT, PC.INR. The patients in this study divided into two groups. Group A: include 50 patients was managed by fissurectomy and lateral internal sphincterotomy Group B: include 50 patients was managed by fissurectomy and digital anal dilatation all patients were followed for 6 months to assess any complications. In this study, they were 60 (60%) females and 40 (40%) males with age ranged from 18 to 66 years with mean ± SD of 36.86 ± 12.60 years. post fissure found in 85%, ant fissure found in 15% Early follow up Group A: two patients (4%) complain of bleeding,4 patients (8%) complain of infection,4 patients (8%) delayed healing ,3 patients (6%) Incontince to liquid and gases Group B:no patients complain of bleeding ,1 patient (2%) infection, no patients delayed healing, 2 patients (4%) Incontince to liquid and gases Late follow up Group A; stenosis in one patient (1%), recurrence in one patient (1%) Group B; no patient complicated by stenosis was recorded; recurrence found in one patient (1%). Both anal dilatation (AD) and Lateral internal sphincterotomy (LIS) provides early pain relief and high ulcer healing rate. However, AD appears to be safer with regard to healing and infection.

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Section: Discussionmentioning

confidence: 99%

Comparative Study Between Fissurectomy and Lateral Sphincterotomy Versus Fissurectomy and Anal Dilatation in Management of Chronic anal Fissure

2022

Al-Azhar University Journal of Virus Researches and Studies

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“…Inflammatory bowel disease and irritable bowel syndrome characterized mostly by diarrhea are risk factors for FI. However, any GI condition that causes frequent bowel movements or a change in bowel habits can lead to FI [17]. And the structural causes of FI are obstetric injuries [18], anorectal surgery [19,20], rectal prolapse [21], and anal intercourse [22].…”

Section: Definition and Etiology Of Fecal Incontinencementioning

confidence: 99%

Is It a Refractory Disease?- Fecal Incontinence; beyond Medication

Lee¹,

Lee²

2022

Ewha Med J

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Fecal incontinence (FI) is recurrent uncontrolled passage of fecal material in patients. The life expectancy of humans has increased. Elderly patients have a significant rate of FI. Therefore, the number of patients with FI will increase. For diagnosis of FI, the digital rectal exam, ultrasonography, and anal manometry are used. In addition, the severity of FI can be assessed using the FI score system by examining symptoms. Recent applications include three-dimensional ultrasonography and other novel approaches. The treatments for FI include biofeedback therapy, anal implant, artificial sphincter, nerve modulation, SECCA, stem cell therapy, and surgical intervention. Biofeedback therapy is a noninvasive procedure. Anal implant, stem cell therapy, and SECCA are all minimally invasive treatments. And more methods constitute intrusive treatment. None of these therapies has been conclusively demonstrated to be superior. Depending on the severity of the symptoms, a non-invasive approach or an intrusive treatment is most frequently employed. In this review, I will discuss the diagnosis and treatment options for FI.

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“…For these reasons, less traumatic, precise, measurable, and reproducible techniques of anal dilatation were recently designed and introduced into practice: balloon dilatation and staged dilatation showed healing rates superimposable to those obtained after internal sphincterotomy, with complication and incontinence rates near zero [309][310][311][312][313][314]. These results were recently confirmed in a long-term follow-up study [315]. Unfortunately, all the studies cited above are mainly focused on chronic anal fissures.…”

Section: Pain Control (See Question 7d)mentioning

confidence: 99%

Anorectal emergencies: WSES-AAST guidelines

et al. 2021

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Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

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The Long-term Effect of Standardized Anal Dilatation for Chronic Anal Fissure on Anal Continence

Cited by 12 publications

References 28 publications

Comparative Study Between Fissurectomy and Lateral Sphincterotomy Versus Fissurectomy and Anal Dilatation in Management of Chronic anal Fissure

Comparative Study Between Fissurectomy and Lateral Sphincterotomy Versus Fissurectomy and Anal Dilatation in Management of Chronic anal Fissure

Is It a Refractory Disease?- Fecal Incontinence; beyond Medication

Anorectal emergencies: WSES-AAST guidelines

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