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Lateral subcutaneous internal sphincterotomy for anal fissure. Technic and experience with 22 cases in children
Insights
Lateral sphincterotomy is the preferred surgical option for treating intractable anal fissures in children. This outpatient procedure minimizes pain and bleeding risks, with only one patient experiencing minor incontinence.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Anal fissures are common in children, often causing significant pain and distress.
- Intractable anal fissures may require surgical intervention when conservative treatments fail.
Purpose of the Study:
- To evaluate the efficacy and safety of lateral sphincterotomy for intractable anal fissures in pediatric patients.
- To determine the optimal surgical approach for managing this condition in children.
Main Methods:
- Lateral sphincterotomy involves dividing the lower half of the internal anal sphincter.
- The procedure is performed through a small external incision at the anal verge, avoiding internal anal canal incisions.
- Outpatient surgical management was utilized.
Main Results:
- Lateral sphincterotomy demonstrated minimal postoperative pain.
- The risk of secondary hemorrhage was eliminated.
- Only one patient (out of the study cohort) experienced minor anal incontinence, indicating a high safety profile.
Conclusions:
- Lateral sphincterotomy is a highly effective and safe surgical treatment for intractable anal fissures in children.
- The procedure's minimally invasive nature and favorable outcomes make it the operation of choice for pediatric patients.
Abstract:
Lateral sphincterotomy is probably the operation of choice for most cases of intractable anal fissure in children. The lower half of the sphincter is divided in the left or right lateral position through a small external incision at the anal verge. An incision in the anal canal itself is avoided, postoperative pain is minimal and the risk of secondary hemorrhage is eliminated. The operation can be done as an outpatient procedure. Only one patient developed minor anal incontinence.