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Analfissur

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Chirurgische Proktologie

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Zusammenfassung

Die Analfissur gehört zu den häufigsten proktologischen Erkrankungen. Durch Einreißen des Anoderms kann es zu einer Überdehnung des Analkanals mit Ausbildung einer Analfissur kommen. Die Fissur beginnt am anokutanen Übergang und kann sich nach oral bis zur Linea dentata ausdehnen. Typische Analfissuren finden sich meist bei 6 Uhr SSL. Die Therapie der Analfissur erfolgt primär konservativ. Alle operativen Eingriffe bei Analfissuren bergen das Risiko der postoperativen Sphinkterinsuffizienz mit der Folge einer Stuhlinkontinenz. Daher sollte nur nach Ausschöpfung aller konservativen und medikamentösen Maßnahmen eine Operation in Erwägung gezogen werden. Im deutschsprachigen Raum hat sich als sphinkterschonendes Verfahren die Fissurektomie mit Exzision der Fissur einschließlich Vorpostenfalte, hypertropher Analpapille, Mariske, vertieften Krypten, ggf. vorliegender Fistel und Narbenrändern als operative Therapie der Wahl etabliert.

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  1. Katharinen-Hospital, Abteilung für Chirurgie, Obere Husemannstraße 2, 59423, Unna, Deutschland

    PD Dr. med. S. Kersting

  2. Prosper Hospital gGmbH, Koloproktologische Klinik, Mühlenstraße 27, 45659, Recklinghausen, Deutschland

    Dr. med. E. Berg

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  1. PD Dr. med. S. Kersting
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Correspondence to S. Kersting or E. Berg .

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  2. End- und Dickdarm-Zentrum Essen, Essen, Deutschland

    Andreas Ommer

  3. Medkongress AG, St. Gallen, Switzerland

    Jochen Lange

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Kersting, S., Berg, E. (2018). Analfissur. In: Mölle, B., Ommer, A., Lange, J., Girona, J. (eds) Chirurgische Proktologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54682-6_5

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