Anal Fissure Treatment Alone or With Other Anal Disorders Under Local Anathesia and in Co Morbid Patients
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 8
Abstract
Introduction: Chronic anal fissure is a common anal problem that can result in a great discomfort. Acute anal fissure responds to conservative treatment, but chronic anal fissure unlikely to heal with conservative treatment. Surgery is considered as an accepted tool to treat chronic anal fissure. Aim: To operate anal fissure under local infiltration anesthesia, to evaluate patient satisfaction during procedure and to evaluate if other anal procedures can be performed in the same session with it. Patients and methods: This prospective, observational study was conducted on patients with chronic anal fissure. Open lateral internal anal sphinctertomy under local anathesia was done. Patient discomfort during the manoeuvre, the need of sedation, patient relaxation, operative time, intraoperative complications, and postoperative complications were evaluated. Results: The study included 102 patients operated as outpatient’s procedures for chronic anal fissure. The most common site of the fissure was posteriorly located (79.4%). Patient’s relaxation was recorded in the majority of cases (94 cases (92.2%) with low pain score. Minor bleeding was the only reported intraoperative complications in (3.9%) of cases. Mild incontinence was the only recorded postoperative complication in (4.9%) of cases. Conclusions: Local anaesthetic infiltration is a well- tolerated, and effective form of anaesthesia when used for open lateral internal anal sphinctertomy as a treatment of anal fissure. This technique reduces the hospital stay, and cost. Patient’s relaxation and satisfaction were excellent.
Authors and Affiliations
Ahmed Soliman, Gamal A Makhlouf, Khaled A. Abdel- Rahman
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