Abstract
The aetiology of anal fissure is not fully understood—why some heal spontaneously and others become chronic remains a mystery. In this study we compared surgical and conservative therapy and investigated which surgical procedure is most useful in the treatment of fissure. There were investigated 308 patients, 157 with acute fissure and 151 with chronic fissure. Healing was achieved in 45±15 days and in 40±10 days in acute fissures treated conservatively and surgically, respectively, 40±15 days and 30±5 days were required to achieve healing in chronic fissure by conservative and surgical therapy, respectively. Manometric tests showed a decrease in resting pressure and maximum voluntary contraction pressure at one month, and an increase towards the pre-operative level at 4 months for both parameters. There were no recurrences at 5 years in 100 patients (50 males and 50 females).
Résumé
L'étiologie de la fissure anale n'est pas parfaitement comprise. Pourquoi certaines cicatrisent spontanément alors que d'autres deviennent chroniques ceci demeure un mystère. Dans cette étude nous avons comparé le traitement chirurgical avec le traitement conservateur et rechercheé pourquoi le traitement chirurgical est plus utile daus le traitement de la fissure. 308 malades ont été investigués, 157 avec une fissure aigue et 171 avec une fissure chronique. La guérison a été obtenue dans 45±15 jours et dans 40±10 jours en cas de fissure aigue traitée conservativement ou chirurgicalement. Alors qu'elles survenaient respectivement en 40±15 jours et 30±5 jours en cas de fissure chronique traitée soit conservativement soit chirurgicalement. Les tests manométriques montraient une diminuation de la pression de repos et de la contraction maximale volontaire à 1 mois, de même qu'une augmentation des deux paramètres par rapport au taux pré-opératoire à 4 mois. II n'ya pas eu de récidive chez 100 malades (50 hommes et 50 femmes) à 5 ans.
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Frezza, E.E., Sandei, F., Leoni, G. et al. Conservative and surgical treatment in acute and chronic anal fissure. A study on 308 patients. Int J Colorect Dis 7, 188–191 (1992). https://doi.org/10.1007/BF00341218
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DOI: https://doi.org/10.1007/BF00341218