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.	蔡兆華, 賈元云. 肛裂的發生及治療機理探討[J]. 大腸肛門病外科雜志, 1998, 4(3):88-89.
15.	謝祖儉. 治療肛裂切斷括約肌問題的討論[J]. 實用醫技雜志, 2003, 10(6):635-636.

1. 張東銘. 盆底與肛門病學[M]. 貴陽:貴州科學技術出版社, 2000:413.
2. 艾儒棣. 中西醫臨床外科學[M]. 北京:中國醫藥科學技術出版社, 2002:654.
3. 中華中醫藥學會肛腸分會. 痔、肛瘺、肛裂、直腸脫垂的診斷標準(試行草案)[J]. 中國肛腸病雜志, 2004, 24(4):42-43.
4. 徐天舒, 錢海華. 針藥結合麻醉下手術治療混合痔40例臨床觀察[J]. 針刺研究, 2009, 34(6):403-405.
5. 中華醫學會, 中華醫院管理學會藥事管理專業委員會, 中國藥學會醫院藥學專業委員會. 抗菌藥物臨床應用指導原則[J]. 中國臨床藥學雜志, 2005, 14(4):13-18.
6. 國家中醫藥管理局. 中醫病癥診斷療效標準[M]. 南京:南京大學出版社, 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, 李寧漢. 實用痔瘺學[M]. 北京:科學技術文獻出版社, 2000:358.
9. Zaghiyan KN, Fleshner P. Anal fissure[J]. Clin Colon Rectal Surg, 2011, 24(1):22-30.
10. 陸金根. 中西醫結合肛腸病學[M]. 北京:中國中醫藥出版社, 2009:201-202.
11. 張東銘. 大腸肛門局部解剖與手術學[M]. 合肥:安徽科學技術出版社, 1998:115.
12. 張東銘. 肛腸外科解剖生理學[M]. 西安:陜西科學技術出版社, 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. 蔡兆華, 賈元云. 肛裂的發生及治療機理探討[J]. 大腸肛門病外科雜志, 1998, 4(3):88-89.
15. 謝祖儉. 治療肛裂切斷括約肌問題的討論[J]. 實用醫技雜志, 2003, 10(6):635-636.

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Clinical Study on Amputation of Internal and External Sphincter in the Treatment of Old Anal Fissure

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