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Keyhole deformity

Fact and fiction

  • Published:
Diseases of the Colon & Rectum

Abstract

The purpose of this paper is to show whether there is a keyhole deformity, its surgical significance, and how often it occurred following surgery for ulcer-in-ano. To do this, a retrospective study, over a 16-year period, of all patients admitted to the Ferguson Clinic with chief complaints of anal incontinence was undertaken. Of this group of patients, seven were identified as having questionable keyhole deformities, three of whom probably had classic defects. There were six females and one male. Only two of the deformities were associated with surgery for ulcer-in-ano. One of these was easily repaired and the other patient had a full rectal prolapse. In addition, of 186 patients undergoing fistula surgery, 77 who had posterior midline transsphincteric fistulas were studied and ten of these patients went on to complete recovery without any permanent problems resulting from severance of the sphincter. It can generally be concluded that, although there is such a defect as the keyhole deformity, it occurs only rarely, especially after surgery for ulcer-in-ano, and that many times it is not associated with anal incontinence.

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References

  1. Abcarian H. Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs. fissurectomy-midline sphincterotomy. Dis Colon Rectum 1980;23:31–6.

    Article  CAS  Google Scholar 

  2. Bailey R, Rubin RJ, Salvati EP. Lateral internal sphincterotomy. Dis Colon Rectum 1978;21:584–3.

    Article  CAS  Google Scholar 

  3. Goldberg SM. Anal incontinence. In: Essentials of anorectal surgery. 1st ed. Philadelphia: JB Lippincott, 282–90.

  4. Goligher JC. Operative trauma and anal incontinence. In: Surgery of the anus, rectum and colon. 4th ed. London; Bailliere Tindall, 311–20.

  5. Hawley PR. The treatment of chronic fissure-in-ano: a trail of methods. Br J Surg 1969;56:915–8.

    Article  CAS  Google Scholar 

  6. Notaras MJ. The treatment of anal fissure by lateral subcutaneous internal sphincterotomy: a technique and results. Br J Surg 1971;58:96–100.

    Article  CAS  Google Scholar 

  7. Ravikumar TS, Sridhar S, Rao RN. Subcutaneous lateral internal sphincterotomy for chronic fissure-in-ano. Dis Colon Rectum 1982;25:798–801.

    Article  CAS  Google Scholar 

  8. Ray JE, Penfold JC, Gathright JB Jr, Roberson SH. Lateral, subcutaneous internal anal sphincterotomy for anal fissure. Dis Colon Rectum 1984;17:139–44.

    Article  Google Scholar 

  9. Bode WE, Culp CE, Spencer RJ, Beart RW Jr. Fissurectomy with superficial midline sphincterotomy: a viable alternative for the surgical correction of chronic fissure/ulcer-in-ano. Dis Colon Rectum 1984;27:93–5.

    Article  CAS  Google Scholar 

  10. Hus TC, MacKeigan JM. Surgical treatment of chronic anal fissure: a retrospective study of 1753 cases (unpublished data).

  11. Mazier WP. An evaluation of the surgical treatment of anal fissures. Dis Colon Rectum 1972;15:222–7.

    Article  CAS  Google Scholar 

  12. Rudd WW. Lateral subcutaneous internal sphincterotomy for chronic anal fissure: an outpatient procedure. Dis Colon Rectum 1975;18:319–23.

    Article  CAS  Google Scholar 

  13. Sohn N, Weinstein MA, Robbins RD. Anorectal disorders. Curr Probl Surg 1983;20:1–66.

    Article  CAS  Google Scholar 

  14. Tchirkow G. Posterior midline sphincterotomy in the treatment of chronic anal fissures. Colo-Proctology 1983;5:31–3.

    Google Scholar 

  15. Eisenhammer BM. The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 1951;25:486–9.

    CAS  PubMed  Google Scholar 

  16. Eisenhammer S. The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure. Surg Gynecol Obstet 1959;109:583–90.

    CAS  PubMed  Google Scholar 

Download references

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Read at the Joint Meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.

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Patrick Mazier, W. Keyhole deformity. Dis Colon Rectum 28, 8–10 (1985). https://doi.org/10.1007/BF02553897

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  • DOI: https://doi.org/10.1007/BF02553897

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