Objective To analyze and compare the clinical efficacy and advantage between two treatments methods for chronic anal fissure. Methods Divided 96 patients with chronic anal fissure into two groups based on the odd and even numbers of treatment order: 48 patients in study group received sequential anal dilation and microwave treatment, and 48 patients in control group received posterior internal sphincterotomy. The blood loss in operation, wound healing time, wound infection rate, anal infection rate, anal control, postoperative defecation function, anal stenosis rate, and the recurrence rate between the two groups were compared and analyzed. Results Blood loss and wound healing time were less in study group than those in control group (Plt;0.01). Anal control was better in study group than that in control group (Plt;0.05). There were no occurrences of wound infection or anal infection, and the defecation function was improved in both of the two groups. There was no recurrence after one year follow-up in both of the two groups. Anal stenosis rate in study group is lower than that in control group (Plt;0.01). Conclusion The technique of sequential anal dilation and microwave treatment can reduce pain, and is simple, effective, and worthy of promotion.
Objective To evaluate the safety and efficacy of botulinum toxin type A injection around internal anal sphincter and sector resection combined with epluchage and drainage by a small incision in treatment for stage Ⅱ and Ⅲ anal fissure，explore its surgical procedures and key points，and introduce a new surgical treatment for anal fissure. Methods The patients according to the inclusive criteria were divided into trial group and control group in randomized，parallel，controlled clinical trial method．The botulinum toxin type A injection around internal anal sphincter and sector resection combined with epluchage and drainage by a small incision was performed in the trial group, the anal fissure resection and part internal anal sphinctor latero-resection was perfermed in the control group. The safety index （including anal stenosis，incontinence，acute urinary retention，postoperative pain，and rectal anal tube pressure） and validity indicators （including cure rate，operation time，wound healing，wound healing grade，and scar size） were compared before and after operation between two groups．Results No anal stenosis and acute urinary retention occurred in the two groups. The anal incontinence score was not significantly different between two groups （P＞0.05）．The postoperative pain score in the trial group was significantly lower than that in the control group （24 h，the first defecation，and on week one after operation，all P＜0.01）．The difference of rectal anal canal pressure was not statistically significant between two groups （P＞0.05）．The cure rate was higher （P＜0.05），operation time and wound healing time were shorter （P＜0.01），wound healing was better （P＜0.05），scar area was smaller （P＜0.01） in the trial group as compared with the control group．Conclusions Comparing with the control group，high cure rate，short wound healing time，small size of scar，short operation time and minimal invasion are seen in the trial group．The shape and function of the anus are better reserved than that of the control group，this technique has a good clinical efficacy and safety．
目的 探讨预防慢性肛裂手术并发症的技巧。方法 回顾性分析近3年笔者所在单位收治的63例慢性肛裂患者的临床资料，男21例，女42例，年龄（34±12）岁（17～51岁），均行肛裂切除术，并在处理内括约肌时采用橡皮筋结扎法，观察术后并发症的发生情况。 结果 所有患者术后恢复良好，无一例出现术后大出血、肛裂复发、肛门失禁等并发症。 结论 通过采用橡皮筋结扎法处理内括约肌，避免了术后并发症的发生，该方法值得推广。
目的 评估倒“V”字皮瓣修复加内括约肌切断术治疗陈旧性肛裂的效果及合理性。方法 回顾性分析2000～2010年期间我院采用肛门后倒“V”字皮瓣修复加内括约肌切断治疗的62例陈旧性肛裂患者的临床资料，并对其效果进行评价。结果 62例患者经过该手术治疗，均痊愈出院。发生切口血肿4例，切口感染1例，暂时性大便渗漏4例。住院时间平均8.6d，术中出血量平均13ml，创口愈合时间平均8d。术后随访6～15个月（平均12个月），均未出现复发，排便情况满意。结论 该术式治愈率高，并发症少，是治疗陈旧性肛裂有效而可行的一种手术方式。
ObjectiveTo observe and assess the therapeutic effect of posterior amputation of internal sphincter and partial external sphincter in the treatment of old anal fissure. MethodsEighty patients with old anal fissure treated between August 2012 and June 2014 were randomly divided into study group and control group with 40 in each. The study group received posterior amputation of internal sphincter and partial external sphincter, while the control group underwent single amputation of internal sphincter. Then we observed the cure rate, wound healing days, pain at defecation after operation, defecation control after operation, and long-term recurrence rate. ResultsAll the 40 patients in study group were healed with a recovery rate of 100%, while 38 in control group were healed with a recovery rate of 95%; the difference between the two groups were not significant (P>0.05). The wound healing time in study group[(17.0±3.5) days] was much longer than that in the control group[(10.5±3.8) days] (P<0.05). The pain extents of fundament during defecating on the first day and 3, 7, and 15 days later in study group were more alleviated than those in the control group (P<0.05). In the six-month follow-up period, one patient in study group had liquid stools out of control 3 months after the surgery, and the others had no similar symptoms (P>0.05). ConclusionPosterior amputation of internal sphincter and partial external sphincter is a reasonable method for the treatment of old anal fissure. It can not only cure old anal fissure but also alleviate pain at defecation after operation and facilitate defecation.
ObjectiveTo summarize the recent development of surgical treatment for chronic anal fissure. MethodsThe related literatures on various operation treatment of anal fissure at home and abroad in recent years were collected and reviewed. ResultsThere 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. ConclusionFor what kind of operation method is the most suitable for the treatment of chronic anal fissure is no fixed conclusion.