دورية أكاديمية
Long-term results of lateral internal sphincterotomy for chronic anal fissure with particular reference to incidence of fecal incontinence.
| العنوان: | Long-term results of lateral internal sphincterotomy for chronic anal fissure with particular reference to incidence of fecal incontinence. |
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| المؤلفون: | Nyam DC; Division of Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA., Pemberton JH |
| المصدر: | Diseases of the colon and rectum [Dis Colon Rectum] 1999 Oct; Vol. 42 (10), pp. 1306-10. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Country of Publication: United States NLM ID: 0372764 Publication Model: Print Cited Medium: Print ISSN: 0012-3706 (Print) Linking ISSN: 00123706 NLM ISO Abbreviation: Dis Colon Rectum Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia. Lippincott |
| مواضيع طبية MeSH: | Anal Canal/*surgery , Fecal Incontinence/*epidemiology , Fissure in Ano/*surgery, Female ; Flatulence/epidemiology ; Follow-Up Studies ; Humans ; Incidence ; Male ; Postoperative Complications/epidemiology ; Time Factors ; Treatment Outcome |
| مستخلص: | Purpose: Lateral internal sphincterotomy is the procedure of choice for chronic anal fissure because it relieves symptoms and heals the fissure in nearly all patients. However, there is evidence that fecal incontinence complicates lateral internal sphincterotomy. The aim of this study was to examine the outcome of lateral internal sphincterotomy in terms of fissure healing and incidence of fecal incontinence. Methods: Between 1984 and 1996, 585 patients underwent lateral internal sphincterotomy and were surveyed by questionnaire. Eighty-three percent (487/585) responded. The mean follow-up was 72 (range, 6-145) months. Results: Fissures had healed by a median of three weeks after surgery in 96 percent of patients. Recurrent fissures occurred in 8 percent. Two thirds of the recurrent fissures healed on conservative management alone. Ninety-eight percent of patients were satisfied with the outcome of surgery, but some degree of fecal incontinence occurred in fully 45 percent of patients at some time in the postoperative period. Incontinence occurred in 53.4 percent of women and 33.3 percent of men (P < 0.05). Incontinence to flatus, mild soiling, and gross incontinence occurred in 31, 39, and 23 percent of patients, respectively. However, by the time of survey (a mean of >5 years after lateral internal sphincterotomy) 6 percent reported incontinence to flatus, 8 percent had minor fecal soiling, and 1 percent experienced loss of solid stool. Importantly, only 3 percent of patients stated that incontinence had ever affected their quality of life. Conclusion: Although lateral internal sphincterotomy heals and relieves symptoms of chronic anal fissure in nearly all patients (96 percent), incontinence occurs frequently. Most episodes of incontinence are indeed minor and transient, but in a small subgroup, incontinence seems to be permanent. |
| تواريخ الأحداث: | Date Created: 19991021 Date Completed: 19991028 Latest Revision: 20220409 |
| رمز التحديث: | 20240627 |
| DOI: | 10.1007/BF02234220 |
| PMID: | 10528769 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0012-3706 |
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| DOI: | 10.1007/BF02234220 |