Clinical Study on Amputation of Internal and External Sphincter in the Treatment of Old Anal Fissure_West China Medical Journal

Authors：

 MuQirong

Department of Integrated TCM & Western Medicine, the First Peoples Hospital of Liangshan, Xichang, Sichuan 615000, P. R. China;

Corresponding author：

Keywords：

nternal sphincter; External sphincter; Old anal fissure; Clinical study

DOI：

10.7507/1002-0179.201600420

Video：

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Objective To observe and assess the therapeutic effect of posterior amputation of internal sphincter and partial external sphincter in the treatment of old anal fissure. Methods Eighty 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. Results All 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). Conclusion Posterior 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.

Citation： MuQirong. Clinical Study on Amputation of Internal and External Sphincter in the Treatment of Old Anal Fissure. West China Medical Journal, 2016, 31(9): 1543-1545. doi: 10.7507/1002-0179.201600420 Copy

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13.	Leong AK. Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure[J]. Dis Colon Recturn, 1995, 38(1):69.
14.	蔡兆华, 贾元云. 肛裂的发生及治疗机理探讨[J]. 大肠肛门病外科杂志, 1998, 4(3):88-89.
15.	谢祖俭. 治疗肛裂切断括约肌问题的讨论[J]. 实用医技杂志, 2003, 10(6):635-636.

1. 张东铭. 盆底与肛门病学[M]. 贵阳:贵州科学技术出版社, 2000:413.
2. 艾儒棣. 中西医临床外科学[M]. 北京:中国医药科学技术出版社, 2002:654.
3. 中华中医药学会肛肠分会. 痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案)[J]. 中国肛肠病杂志, 2004, 24(4):42-43.
4. 徐天舒, 钱海华. 针药结合麻醉下手术治疗混合痔40例临床观察[J]. 针刺研究, 2009, 34(6):403-405.
5. 中华医学会, 中华医院管理学会药事管理专业委员会, 中国药学会医院药学专业委员会. 抗菌药物临床应用指导原则[J]. 中国临床药学杂志, 2005, 14(4):13-18.
6. 国家中医药管理局. 中医病症诊断疗效标准[M]. 南京:南京大学出版社, 1994.
7. Karanlik H, Akturk R, Camlica H, et al. The effect of glyceryl trinitrate ointment on posthemorrhoidectomy pain and wound healing:results of a randomized, double-blind, placebo-controlled study[J]. Dis Colon Rectum, 2009, 52(2):280-285.
8. 胡伯虎, 李宁汉. 实用痔瘘学[M]. 北京:科学技术文献出版社, 2000:358.
9. Zaghiyan KN, Fleshner P. Anal fissure[J]. Clin Colon Rectal Surg, 2011, 24(1):22-30.
10. 陆金根. 中西医结合肛肠病学[M]. 北京:中国中医药出版社, 2009:201-202.
11. 张东铭. 大肠肛门局部解剖与手术学[M]. 合肥:安徽科学技术出版社, 1998:115.
12. 张东铭. 肛肠外科解剖生理学[M]. 西安:陕西科学技术出版社, 1989:40.
13. Leong AK. Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure[J]. Dis Colon Recturn, 1995, 38(1):69.
14. 蔡兆华, 贾元云. 肛裂的发生及治疗机理探讨[J]. 大肠肛门病外科杂志, 1998, 4(3):88-89.
15. 谢祖俭. 治疗肛裂切断括约肌问题的讨论[J]. 实用医技杂志, 2003, 10(6):635-636.

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