Lateral Subcutaneous Internal Sphincterotomy in Treatment of Anal Fissure

Hoffmann, D. C.; Goligher, J. C.

doi:10.1136/bmj.3.5724.673

Cited by 116 publications

(48 citation statements)

References 9 publications

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“…At this point, the internal sphincter is divided, cutting laterally to medially toward the surgeon's finger in the anal canal. [46], [47] Since the 1950s and 1960s, numerous studies have evaluated different methods of sphincterotomy. Various randomized controlled trials have compared open versus closed techniques.…”

Section: Division Of Internal Anal Sphinctermentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

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Anal fissure is one of the most common anorectal problems. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. There are many options to treat chronic fissures in ano. Some of them are non-surgical while the others are surgical. The efficacy claimed by each of the prevalent method is very high but the inconsistencies and contraindications are equally strong. To date, lateral sphincterotomy has been favoured by most of the proctologists, because it is the least extensive surgical procedure and is offering a long lasting relief in sphincter spasm. Various management technique are reviewed in this article along with Advancement flap for anterior fissure and a new method combining the age-old technique of Lord's manual dilatation followed by radio surgery is also highlighted along with their complications. The addition of radio surgery is found useful for refreshing the edges of the fissure and to tackle pathologies namely sentinel pile, small internal piles or hypertrophied anal papillae often found associated with chronic fissures. Revisiting the trends of treatment of chronic anal fissures, the most preferred options are the manual dilatation with radio surgery and the subcutaneous lateral anal sphincterotomy. Both methods are easy to perform, have negligible complications and no special setup is needed, except the radio surgical unit, in case of the first procedure.

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Section: Division Of Internal Anal Sphinctermentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

View full text Add to dashboard Cite

show abstract

“…As regard mean analgesic requirement in study period of 14 days, patients used an average of 18 tablets (range [11][12][13][14][15][16][17][18][19][20][21][22][23][24] in the placebo group compared with 25 tablets (range 15-30 tablets) in the chili group.…”

Section: Discussionmentioning

confidence: 99%

Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial

Gupta¹

2008

Arq. Gastroenterol.

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-Background -Red-hot chili pepper and other spices have been blamed for causing or exacerbating symptoms of anal pathologies like anal fissure and hemorrhoids. Aim -To determine if consumption of chilies increases symptoms of acute anal fissures. Methods -Individual patients were randomized to receive capsules containing chili or placebo for one week in addition to analgesics and fiber supplement. Patients were asked to note score for symptoms like pain, anal burning, and pruritus during the study period. After 1 week, cross over treatment was administered to the same group of patients with the same methodology and results were noted at the end of 2 weeks. Results -Fifty subjects were recruited for this study. Forty three of them completed the trial (22 in the chili group and 21 in the placebo group). The daily mean pain score was significantly lower in the placebo group in the study period. Score 2.05 in chili group and 0.97 in placebo group. There was a significant burning sensation experienced by the patients in the chili group (score 1.85 for the chili group vs 0.71 for the placebo group). Patient's mean recorded improvement score was significantly higher after taking placebo. Eighty one point three percent patients preferred placebo while 13.9% preferred chilies. Two patients had no preference. Conclusion -Consumption of chili does increase the symptoms of acute anal fissure and reduces patient compliance. HEADINGS -Fissure in ano. Pimenta. Capsaicin. Spices.

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“…of the patient. [3][4][5] This study is made with partial sphincterotomy i.e., division of internal sphincter below the dentate line. 6 Post-operative follow up and symptoms are made into account, in such cases treated adequately.…”

Section: Introductionmentioning

confidence: 99%

Lateral partial internal sphincterotomy-a complete relief in chronic fissure in ANO

Kumar

Selvaraj

2017

Int Surg J

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INTRODUCTIONChronic fissure in ano is very common in all age group of people due to present days hi-fi method of food habits, modified life style and inborn errors of health conscience. The present generation is more moribund on the development of technology and work styles of these techis are tedious. Requirement of the remedies are long standing, permanent and symptom or complication free. Early mobilization after any procedure is the only way out for earned population. In the development of the internet medicine access leads to the attitude of clearance of the physician doubts. Based on the above wide range of criteria among these lies the choice of the treatment to be very selective and preferably high in placement of the best treatment for them.Lateral internal sphincterotomy is the only choice in the treatment of the fissure in ano. Complete Sphincterotomy and partial sphincterotomy was followed in variable individuals. 1,2 But post-operative complication like incontinence is to be made into account for the follow up ABSTRACT Background: Lateral internal sphincterotomy is the only choice in the treatment of the fissure in ano. Complete and partial sphincterotomy was followed in variable individuals. But post-operative complication like incontinence, early mobilization and early recovery is to be made into account for best results among these patients. Methods: This study is made in 2015-2016 period among 52 patients with chronic fissure in ano, partial sphincterotomy i.e., division of internal sphincter below the dentate line was performed. Post-operative follows up and symptoms were recorded, in such cases treated adequately. The period of revisit was decided according to patient compliance 1 month, 3months, 6 months. The data was collected prospectively and recorded in view of change in the treatment. Results: 47 of the patients were pain free within first 5 days of surgery. Remaining 5 patients required further division for pain relief due to persistent pain after 3 weeks. The associated post-operative complication among these patients was itching due to burning sensation in and around the anus which resolved later. None among these patients developed fecal incontinence. Conclusions: Among all age group of the patients included in this study were subjected to same type of the procedure and results were recorded to give better prognosis with lowest degree of recurrence for which repeat of the same procedure gave the complete relief. Lateral internal partial sphincterotomy is an effective technique for complete relief of pain in chronic fissure in ano.

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Lateral Subcutaneous Internal Sphincterotomy in Treatment of Anal Fissure

Abstract: Eisenhammer (1951) and Goligher, Leacock, and Brossy (1955) to be the spastic prominent lower edge of the internal

Cited by 116 publications

References 9 publications

Anal Fissure Revisited : A Systematic Review

Anal Fissure Revisited : A Systematic Review

Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial

Lateral partial internal sphincterotomy-a complete relief in chronic fissure in ANO

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