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Clinical, functional and morphologic evaluation of patients undergoing lateral sphincterotomy for chronic anal fissure treatment. Identification of factors that can interfere with fecal continence

Avaliação clínica, funcional e morfológica de pacientes submetidas à esfincterotomia para tratamento da fissura anal. Identificação dos fatores que podem interferir na continência fecal

Graziela Olivia da Silva Fernandes Sthela Maria Murad-Regadas Francisco Sérgio Pinheiro Regadas Lusmar Veras Rodrigues Iris Daiana Dealcanfreitas Jacyara de Jesus Rosa Pereira Erico de Carvalho Holanda Francisco Sérgio Pinheiro Regadas FilhoAbout the authors

Objective:

Evaluate clinical, functional and morphologic outcomes of lateral sphincterotomy for chronic anal fissure treatment, and correlate the findings with factors that influence in the anal continence.

Method:

In a prospective study, female patients treated by lateral sphincterotomy for chronic anal fissure were assessed using Wexner's incontinence score and grouped according to score: group I (score = 0) and group 2 (score ≥1) and evaluated with anal manometry and anorectal 3D ultrasonography.

Results:

Thirty-six womens were included, 33% had vaginal delivery. Seventeen patients were included in group I and 19 in group II. We found no difference in age, parity and mode of delivery between groups. A significant difference with respect to percentage reduction in resting pressures was noted, when comparing group 1 versus group 2. The anal sphincter muscle length was similar in both groups. However, the length and percentage of transected internal anal sphincter was significantly greater in group II.

Conclusion:

There was a correlation between fecal incontinence symptoms after sphincterotomy with the percentage of resting pressure reduction, length and percentage of transected internal anal sphincter.

Chronic anal fissure; Lateral internal sphincterotomy; Anorectal manometry; Anorectal three-dimensional ultrasound


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