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[Internal lateral sphincterectomy. Results].

L Viso Pons, J Beatobe Muntada

    Revista Espanola De Las Enfermedades Del Aparato Digestivo
    |June 1, 1989
    PubMed
    Summary

    Internal lateral sphincterotomy is the ideal surgery for anal fissures, offering minimal pain and recurrence. Avoid additional procedures, even minor ones, for best patient outcomes in fissure treatment.

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    Area of Science:

    • Colorectal surgery
    • Gastroenterology
    • Surgical outcomes

    Context:

    • Anal fissure is a common condition requiring surgical intervention.
    • Evaluating surgical techniques for anal fissure treatment is crucial for optimizing patient care.
    • Prospective studies are essential for assessing the efficacy and safety of surgical procedures.

    Purpose:

    • To compare the outcomes of three surgical approaches for anal fissure: internal lateral sphincterotomy (ELI), ELI with fibroma resection (ELI + FC), and sphincterotomy with hemorrhoidectomy (E + H).
    • To evaluate postoperative pain, hospitalization duration, follow-up requirements, complications, and recurrence rates for each surgical group.

    Summary:

    • Internal lateral sphincterotomy (ELI) resulted in the lowest postoperative pain (12%) and shortest follow-up (90% requiring one visit).
    • Combined procedures (ELI + FC and E + H) showed increased pain (42-50%), longer hospital stays (50% >24 hours for E + H), and more extensive follow-up (85% >2 visits for ELI + FC, 100% >3 visits for E + H).
    • All surgical groups had a low incidence of mild complications (9%) and no reported cases of incontinence or fissure recurrence.

    Impact:

    • Internal lateral sphincterotomy is recommended as the primary surgical treatment for anal fissures due to its favorable outcome profile.
    • Minimally invasive approaches and avoiding adjunctive procedures, regardless of perceived significance, are advised to enhance patient recovery and satisfaction.
    • The findings support a conservative approach, emphasizing the efficacy of isolated internal lateral sphincterotomy for anal fissure management.

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