Advances on Surgical Treatment of Anal Fissure_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 OUQiang ¹ , ZHUPing ¹ , CHENYi-qi ² , ZHUBing-yi ² ,  GUYun-fei ²

1. Nanjing University of Traditional Chinese Medicin, Nanjing 210029, Jiangsu Province, China;
2. Department of Colorectal Surgery, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China;

Corresponding author：

GUYun-fei, Email: Guyunfei127@126.com

Keywords：

Chronic anal fissure; Surgical treatment

DOI：

10.7507/1007-9424.20140029

Video：

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Objective To summarize the recent development of surgical treatment for chronic anal fissure. Methods The related literatures on various operation treatment of anal fissure at home and abroad in recent years were collected and reviewed. Results There are many operation treatment methods of anal fissure, includes the closed or open lateral internal sphincterotomy, excision of anal fissure, skin flap plasty, and other operation modes.The different operation methods each has its advantages and disadvantages, but there are a certain percentage of the incidence of complications and the recurrence risk. Conclusion For what kind of operation method is the most suitable for the treatment of chronic anal fissure is no fixed conclusion.

Citation： OUQiang, ZHUPing, CHENYi-qi, ZHUBing-yi, GUYun-fei. Advances on Surgical Treatment of Anal Fissure. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(1): 126-129. doi: 10.7507/1007-9424.20140029 Copy

1.	Dalvid EB, Patricia LR, Theodore JS, et al.The ASCRS text-book of colon and rectal surgery[M].New York:Springer Science and Business Media LLC, 2011:203-218.
2.	Nelson R.Non surgical therapy for anal fissure[J].Cochrane Database Syst Rev, 2012, 2:CD003431.
3.	Lambe GF, Driver CP, Morton S, et al.Fissurectomy as a treatment for anal fissures in children[J].Ann R Coll Surg Engl, 2000, 82(4):254-257.
4.	Schornagel IL, Witvliet M, Engel AF.Five-year results of fissur-ectomy for chronic anal fissure:low recurrence rate and minimal effect on continence[J].Colorectal Dis, 2012, 14(8):997-1000.
5.	陈红风.中医外科学[M].第2版.北京:人民卫生出版社, 2012:285-285.
6.	师源, 师常成.改良纵切横缝术在慢性肛裂治疗中的临床疗效观察[J].广州医药, 2012, 43(1):16-17.
7.	石章铁, 钟艳, 彭东辉.改良纵切横缝术治疗慢性肛裂的临床研究[J].结直肠肛门外科, 2010, 16(3):146-148.
8.	Mousavi SR, Sharifi M, Mehdikhah Z.A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure[J].J Gastrointest Surg, 2009, 13(7):1279-1282.
9.	Lestar B, Penninckx F, Kerremans R.The composition of anal bassl pressure.An in vivo and in vitro study in man[J].Int J Colorectal Dis, 1989, 4(2):118-122.
10.	Eiseenhammer S.The surgical correction of chronic internal anal (sphincteric) contracture[J].S Afr Med J, 1951, 25(28):486-489.
11.	Notaras MJ.Lateral subcutaneous sphincterotomy for anal fissure-a new technique[J].Proc R Soc Med, 1969, 62(7):713.
12.	Perry WB, Dykes SL, Buie WD, et al.Practice parameters for the management of anal fissures[J].Dis Colon Rectum, 2010, 53(8):1110-1115.
13.	Ticmeanu F, Berevoescu NI.Treatment of chronic anal fissure using closed internal and lateral sphincterotomy[J].Chirurgia, 2005, 100(2):133-137.
14.	应光耀, 张志君, 沙喜.特型小针刀对侧切术治疗陈旧性肛裂临床观察[J].实用中医药杂志, 2011, 27(6):402-403.
15.	Ersoz F, Arikan S, Sari S, et al.Type of lateral internal sphinct-erotomy incision:parallel or vertical?[J].World J Surg, 2011, 35(5):1137-1141.
16.	Hyman N.Incontinence after lateral internal sphincterotomy:a prospective study and quality of life assessment[J].Dis Colon Rectum, 2004, 47(1):35-38.
17.	Garcia-Aguilar J, Belmonte C, Wong WD, et al.Open vs.closed sphincterotomy for chronic anal fissure:long-term results[J].Dis Colon Rectum, 1996, 39(4):440-443.
18.	García-Granero E, Sanahuja A, García-Botello SA, et al.The ideal lateral internal sphincterotomy:clinical and endosonographic evaluation following open and closedinternal anal sphincterotomy[J].Colorectal Dis, 2009, 11(5):502-507.
19.	Garcea G, Sutton C, Mansoori S, et al.Results following conse-rvative lateral sphincterotomy for the treatment of chronic anal fissures[J].Colorectal Dis, ,2003, 5(4):311-314.
20.	Chambers W, Sajal R, Dixon A.V-Y advancement flap as first-line treatment for all chronic anal fissures[J].Int J Colorectal Dis, 2010, 25(5):645-648.
21.	Magdy A, El Nakeeb A, Fouda el Y, et al.Comparative study of conventional lateral internal sphincterotomy, V-Y anoplasty, and tailored lateral internal sphincterotomy with V-Y anoplasty in the treatment of chronic anal fissure[J].J Gastrointest Surg, 2012, 16(10):1955-1962.
22.	Hancke E, Rikas E, Suchan K, et al.Dermal flap coverage for chronic anal fissure:lower incidence of anal incontinence compared tolateral internal sphincterotomy after long-term follow-up[J].Dis Colon Rectum, 2010, 53(11):1563-1568.
23.	Giordano P, Gravante G, Grondona P, et al.Simple cutaneous advancement flap anoplasty for resistant chronic anal fissure:a prospective study[J].World J Surg, 2009, 33(5):1058-1063.
24.	Patti R, Fam F, Barrera T, et al.Fissurectomy and anal advanc-ement flap for anterior chronic anal fissure without hypertonia of the internal analsphincter in females[J].Colorectal Dis, 2010, 12(11):1127-1130.
25.	Alver O, Ersoy YE, Aydemir I, et al.Use of "house" advancement flap in anorectal diseases[J].World J Surg, 2008, 32(10):2281-2286.
26.	Nelson RL, Chattopadhyay A, Brooks W, et al.Operative procedures for fissure in ano[J].Cochrane Database Syst Rev, 2011, 9(11):CD002199.
27.	Gee T, Hisham RB, Jabar MF, et a1.Ano-coccygeal support in the treatment of idiopathic chronic posterior anal fissure:a pros-pective non-randomised controlled pilot trial[J].Tech Coloproctol, 2013, 17(2):181-186.
28.	Minguez M, Herreros B, Benages A.Chronic anal fissure[J].Curt Treat Option Gastroenterol, 2003, 6(3):257-262.
29.	Levin A, Cohen MJ, Mindrul V, et al.Delayed fecal incontinence following surgery for anal fissure[J].Int J Colorectal Dis, 2011, 26(12):1595-1599.
30.	Brown CJ, Dubreuil D, Santoro L, et al.Lateral internal sphincterotomy is superior to topical nitroglycerin for healing chronic anal fissure and does not compromise long-term fecal continence:six-year follow-up of a multicenter, randomized, controlled trial[J].Dis Colon Rectum, 2007, 50(14):442-448.
31.	Garg P, Garg M, Menon GR.Long term continence disturbance after lateral internal sphincterotomy for chronic anal fissure:a systematic review and meta-analysis[J].Colorectal Dis, 2013, 15(3):e104-e117.
32.	Perry WB, Dykes SL, Buie WD, et al.Practice parameters for the management of anal fissures (3rd revision).[J].Dis Colon Rectum, 2010, 53(8):1110-1115.
33.	Murad-Regadas SM, Fernandes GO, Regadas FS, et al.How much of the internal sphincter may be divided during lateral sphincterotomy for chronic anal fissure in women? Morphologic and functional evaluation after sphincterotomy[J].Dis Colon Rectum, 2013, 56(5):645-651.
34.	Patel SD, Oxenham T, Praveen BV.Medium-term results of anal advancement flap compared with lateral sphincterotomy for the treatment of anal fissure[J].Int J Colorectal Dis, 2011, 26(9):1211-1214.

1. Dalvid EB, Patricia LR, Theodore JS, et al.The ASCRS text-book of colon and rectal surgery[M].New York:Springer Science and Business Media LLC, 2011:203-218.
2. Nelson R.Non surgical therapy for anal fissure[J].Cochrane Database Syst Rev, 2012, 2:CD003431.
3. Lambe GF, Driver CP, Morton S, et al.Fissurectomy as a treatment for anal fissures in children[J].Ann R Coll Surg Engl, 2000, 82(4):254-257.
4. Schornagel IL, Witvliet M, Engel AF.Five-year results of fissur-ectomy for chronic anal fissure:low recurrence rate and minimal effect on continence[J].Colorectal Dis, 2012, 14(8):997-1000.
5. 陈红风.中医外科学[M].第2版.北京:人民卫生出版社, 2012:285-285.
6. 师源, 师常成.改良纵切横缝术在慢性肛裂治疗中的临床疗效观察[J].广州医药, 2012, 43(1):16-17.
7. 石章铁, 钟艳, 彭东辉.改良纵切横缝术治疗慢性肛裂的临床研究[J].结直肠肛门外科, 2010, 16(3):146-148.
8. Mousavi SR, Sharifi M, Mehdikhah Z.A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure[J].J Gastrointest Surg, 2009, 13(7):1279-1282.
9. Lestar B, Penninckx F, Kerremans R.The composition of anal bassl pressure.An in vivo and in vitro study in man[J].Int J Colorectal Dis, 1989, 4(2):118-122.
10. Eiseenhammer S.The surgical correction of chronic internal anal (sphincteric) contracture[J].S Afr Med J, 1951, 25(28):486-489.
11. Notaras MJ.Lateral subcutaneous sphincterotomy for anal fissure-a new technique[J].Proc R Soc Med, 1969, 62(7):713.
12. Perry WB, Dykes SL, Buie WD, et al.Practice parameters for the management of anal fissures[J].Dis Colon Rectum, 2010, 53(8):1110-1115.
13. Ticmeanu F, Berevoescu NI.Treatment of chronic anal fissure using closed internal and lateral sphincterotomy[J].Chirurgia, 2005, 100(2):133-137.
14. 应光耀, 张志君, 沙喜.特型小针刀对侧切术治疗陈旧性肛裂临床观察[J].实用中医药杂志, 2011, 27(6):402-403.
15. Ersoz F, Arikan S, Sari S, et al.Type of lateral internal sphinct-erotomy incision:parallel or vertical?[J].World J Surg, 2011, 35(5):1137-1141.
16. Hyman N.Incontinence after lateral internal sphincterotomy:a prospective study and quality of life assessment[J].Dis Colon Rectum, 2004, 47(1):35-38.
17. Garcia-Aguilar J, Belmonte C, Wong WD, et al.Open vs.closed sphincterotomy for chronic anal fissure:long-term results[J].Dis Colon Rectum, 1996, 39(4):440-443.
18. García-Granero E, Sanahuja A, García-Botello SA, et al.The ideal lateral internal sphincterotomy:clinical and endosonographic evaluation following open and closedinternal anal sphincterotomy[J].Colorectal Dis, 2009, 11(5):502-507.
19. Garcea G, Sutton C, Mansoori S, et al.Results following conse-rvative lateral sphincterotomy for the treatment of chronic anal fissures[J].Colorectal Dis, ,2003, 5(4):311-314.
20. Chambers W, Sajal R, Dixon A.V-Y advancement flap as first-line treatment for all chronic anal fissures[J].Int J Colorectal Dis, 2010, 25(5):645-648.
21. Magdy A, El Nakeeb A, Fouda el Y, et al.Comparative study of conventional lateral internal sphincterotomy, V-Y anoplasty, and tailored lateral internal sphincterotomy with V-Y anoplasty in the treatment of chronic anal fissure[J].J Gastrointest Surg, 2012, 16(10):1955-1962.
22. Hancke E, Rikas E, Suchan K, et al.Dermal flap coverage for chronic anal fissure:lower incidence of anal incontinence compared tolateral internal sphincterotomy after long-term follow-up[J].Dis Colon Rectum, 2010, 53(11):1563-1568.
23. Giordano P, Gravante G, Grondona P, et al.Simple cutaneous advancement flap anoplasty for resistant chronic anal fissure:a prospective study[J].World J Surg, 2009, 33(5):1058-1063.
24. Patti R, Fam F, Barrera T, et al.Fissurectomy and anal advanc-ement flap for anterior chronic anal fissure without hypertonia of the internal analsphincter in females[J].Colorectal Dis, 2010, 12(11):1127-1130.
25. Alver O, Ersoy YE, Aydemir I, et al.Use of "house" advancement flap in anorectal diseases[J].World J Surg, 2008, 32(10):2281-2286.
26. Nelson RL, Chattopadhyay A, Brooks W, et al.Operative procedures for fissure in ano[J].Cochrane Database Syst Rev, 2011, 9(11):CD002199.
27. Gee T, Hisham RB, Jabar MF, et a1.Ano-coccygeal support in the treatment of idiopathic chronic posterior anal fissure:a pros-pective non-randomised controlled pilot trial[J].Tech Coloproctol, 2013, 17(2):181-186.
28. Minguez M, Herreros B, Benages A.Chronic anal fissure[J].Curt Treat Option Gastroenterol, 2003, 6(3):257-262.
29. Levin A, Cohen MJ, Mindrul V, et al.Delayed fecal incontinence following surgery for anal fissure[J].Int J Colorectal Dis, 2011, 26(12):1595-1599.
30. Brown CJ, Dubreuil D, Santoro L, et al.Lateral internal sphincterotomy is superior to topical nitroglycerin for healing chronic anal fissure and does not compromise long-term fecal continence:six-year follow-up of a multicenter, randomized, controlled trial[J].Dis Colon Rectum, 2007, 50(14):442-448.
31. Garg P, Garg M, Menon GR.Long term continence disturbance after lateral internal sphincterotomy for chronic anal fissure:a systematic review and meta-analysis[J].Colorectal Dis, 2013, 15(3):e104-e117.
32. Perry WB, Dykes SL, Buie WD, et al.Practice parameters for the management of anal fissures (3rd revision).[J].Dis Colon Rectum, 2010, 53(8):1110-1115.
33. Murad-Regadas SM, Fernandes GO, Regadas FS, et al.How much of the internal sphincter may be divided during lateral sphincterotomy for chronic anal fissure in women? Morphologic and functional evaluation after sphincterotomy[J].Dis Colon Rectum, 2013, 56(5):645-651.
34. Patel SD, Oxenham T, Praveen BV.Medium-term results of anal advancement flap compared with lateral sphincterotomy for the treatment of anal fissure[J].Int J Colorectal Dis, 2011, 26(9):1211-1214.

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Advances on Surgical Treatment of Anal Fissure

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