PMID: 32129179Mar 5, 2020Paper

The effect of anorectal manometric examination on the surgical treatment plan in chronic anal fissure.

Annali italiani di chirurgia
Ugur TopalOmer Alabaz

Abstract

Although lateral internal sphincterotomy (LIS) is the most preferred surgical treatment for chronic anal fissure, In this study, we aimed to investigate the effect of preoperative anorectal manometry on surgical treatment choice in patients presenting with anal fissure. Between January-2015 and August-2017 and whose physical examination revealed chronic anal fissure findings were included in the study. Patients were divided into two groups as Group 1 LIS and Group 2 non-LIS. In addition to the demographic characteristics of the patients, anal manometry findings and its effect on surgical treatment options were examined. 20 patients (M/F:13/7) were included in the study. The mean age was 48.3+17.4 in Group 1 and 45.25 +24.45 in Group 2 (p:0.797). In the preoperative manometric examination, resting pressure(mmHg) range was 93.2+15.9 in Group 1, and44+11.2 in Group 2 (30-57) (p:0.001). Endurance to squeezing time was shorter in Group 2 (p:0.0138). There were no differences between the groups in terms of mean squeezing pressure, rectal sensation, and rectoanal inhibitor reflex (p>0.05). Of the four patients with low sphincter pressures, 3 underwent botulinum toxin injection and 1 underwent advancement flap instead of LIS. There was...Continue Reading

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