Conséquences fonctionnelles de la chirurgie du canal anal

  • A. Senéjoux

Résumé

Il n’existe pas de traitement chirurgical validé des sténoses anales postopératoires. Les sténoses de la partie haute du canal anal sont de traitement plus difficile que les sténoses de la partie basse. Les gestes de fistulotomie pour fistules anales basses peuvent induire des troubles de la continence (le plus souvent mineurs) dans 3 % des cas. La réalisation d’une traction élastique débutée immédiatement après un geste de drainage d’une fistule haute expose à un risque d’incontinence chez un malade sur deux. Si la sphinctérotomie interne est actuellement le traitement chirurgical de référence de la fissure anale chronique, elle induit de façon irréversible, des troubles modérés à sévères de la continence fécale dans 5 % des cas. Les malades à qui on propose un tel geste doivent en être informés avant l’intervention. Certaines pratiques chirurgicales associées au traitement des hémorroïdes internes augmentent significativement le risque d’incontinence fécale: dilatation anale ou sphinctérotomie interne systématiques doivent être abandonnées.

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Copyright information

© Springer-Verlag France 2005

Authors and Affiliations

  • A. Senéjoux
    • 1
  1. 1.Hôpital Léopold-BellanParis

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