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Ragade anale

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Prevenzione e trattamento delle complicanze in chirurgia proctologica

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Riassunto

Non occorre soffermarci sulla definizione, sull’incidenza e sul trattamento conservativo. Non lo faremo neppure, salvo poche eccezioni, per le prossime patologie, daremo per scontato che lo si sappia e lasceremo così maggior spazio per il tema specifico del libro ovvero come prevenire e curare le complicanze relative alla terapia chirurgica. Invece va detto qualcosa sulla patogenesi.

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Letture consigliate

  • Abcarian H (1980) Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs. fissurectomy-midline sphincterotomy. Dis Colon Rectum 23:31–36

    Article  PubMed  CAS  Google Scholar 

  • Aigner F, Conrad F (2008) Fissurectomy for treatment of chronic anal fissures. Dis Colon Rectum 51:1163

    Article  PubMed  Google Scholar 

  • Algaithy ZK (2008) Botulinum toxin versus surgical sphincterotomy in females with chronic anal fissure. Saudi Med J 29:1260–1263

    PubMed  Google Scholar 

  • Altomare DF, Rinaldi M, Troilo VL et al (2005) Closed ambulatory lateral internal sphincterotomy for chronic anal fissures. Tech Coloproctol 9:248–249

    PubMed  CAS  Google Scholar 

  • Altomare DF, Binda GA, Canuti S et al (2011) The management of patients with primary chronic anal fissure: a position paper. Tech Coloproctol 15:135–141

    Article  PubMed  CAS  Google Scholar 

  • Argov S, Levandovsky O (2000) Open lateral sphincterotomy is still the best treatment for chronic anal fissure. Am J Surg 179:201–202

    Article  PubMed  CAS  Google Scholar 

  • Arroyo A, Pérez F, Serrano P et al (2004) Open versus closed lateral sphincterotomy performed as an outpatient procedure under local anesthesia for chronic anal fissure: prospective randomized study of clinical and manometric long term results. J Am Coll Surg 199:361–367

    Article  PubMed  Google Scholar 

  • Arthur JD, Makin CA, El-Sayed TY et al (2008) A pilot comparative study of fissurectomy/diltiazem and fissurectomy/botulinum toxin in the treatment of chronic anal fissure. Tech Coloproctol 12:331–336

    Article  PubMed  CAS  Google Scholar 

  • Badejo OA (1984) Outpatient treatment of fissure-in-ano. Trop Geogr Med 36:367–369

    PubMed  CAS  Google Scholar 

  • Baraza W, Boereboom C, Shorthouse A et al (2008) The long-term efficacy of fissurectomy and botulinum toxin injection for chronic anal fissure in females. Dis Colon Rectum 51:239–243

    Article  PubMed  Google Scholar 

  • Boschetto S, Giovannone M, Tosoni M et al (2004) Hydropneumatic anal dilation in conservative treatment of chronic anal fissure: clinical outcomes and randomized comparison with topical nitroglycerin. Tech Coloproctol 8:89–92

    Article  PubMed  CAS  Google Scholar 

  • Brisinda G, Cadeddu F, Mazzeo P et al (2007) Botulinum toxin A for the treatment of chronic anal fissure. Expert Rev Gastroenterol Hepatol 1:219–228

    Article  PubMed  CAS  Google Scholar 

  • Brown CJ, Dubreuil D, Santoro L et al (2007) Lateral internal sphincterotomy is superior to topical nitroglycerin for healing chronic anal fissure and does not compromise long-term fecal continence: six-year follow-up of a multicenter, randomized, controlled trial. Dis Colon Rectum 50:442–448

    Article  PubMed  Google Scholar 

  • Cerdán FJ, Ruiz de León A, Azpiroz F et al (1982) Anal sphincteric pressure in fissure-in-ano before and after lateral internal sphincterotomy. Dis Colon Rectum 25:198–201

    Article  PubMed  Google Scholar 

  • Chambers W, Sajal R, Dixon A (2010) V-Y advancement flap as first-line treatment for all chronic anal fissures. Int J Colorectal Dis 25:645–648

    Article  PubMed  Google Scholar 

  • Cho DY (2005) Controlled lateral sphincterotomy for chronic anal fissure. Dis Colon Rectum 48:1037–1041

    Article  PubMed  Google Scholar 

  • Collins EE, Lund JN (2007) A review of chronic anal fissure management. Tech Coloproctol 11:209–223

    Article  PubMed  CAS  Google Scholar 

  • Conaghan P, Farouk R (2010) Anal fissure healing and sphincter preservation can be successfully achieved in most patients with chronic anal fissure. ASCRS Meeting Abstracts, Dis Colon Rectum 53:587

    Google Scholar 

  • Cundall JD, Gardiner A, Laden G et al (2003) Use of hyperbaric oxygen to treat chronic anal fissure. Br J Surg 90:452–453

    Article  PubMed  CAS  Google Scholar 

  • Elsebae MM (2007) A study of fecal incontinence in patients with chronic anal fissure: prospective, randomized, controlled trial of the extent of internal anal sphincter division during lateral sphincterotomy. World J Surg 31:2052–2057

    Article  PubMed  Google Scholar 

  • Farouk R, Monson JR, Duthie GS (1997) Technical failure of lateral sphincterotomy for the treatment of chronic anal fissure: a study using endoanal ultrasonography. Br J Surg 84:84–85

    PubMed  CAS  Google Scholar 

  • Favetta U, Amato A, Interisano A et al (1996) Clinical, manometric and sonographic assessment of the anal sphincters. A comparative prospective study. Int J Colorectal Dis 11:163–166

    Article  PubMed  CAS  Google Scholar 

  • Favetta U, Amato A, Interisano A et al (1994) Comparative evaluation of anal resting tone and sphincter relaxation by means of digital exploration, anorectal manometry and anal ultrasound. Tech Coloproctol 3:14–15

    Google Scholar 

  • Filingeri V, Gravante G (2005) A prospective randomized trial between subcutaneous lateral internal sphincterotomy with radiofrequency bistoury and conventional Parks’ operation in the treatment of anal fissures. Eur Rev Med Pharmacol Sci 9:175–178

    PubMed  CAS  Google Scholar 

  • Garcea G, Sutton C, Mansoori S et al (2003) Results following conservative lateral sphincteromy for the treatment of chronic anal fissures. Colorectal Dis 5:311–314

    Article  PubMed  CAS  Google Scholar 

  • García-Granero E, Sanahuja A, García-Botello SA et al (2009) The ideal lateral internal sphincterotomy: clinical and endosonographic evaluation following open and closed internal anal sphincterotomy. Colorectal Dis 11:502–507

    Article  PubMed  Google Scholar 

  • Giordano P, Gravante G, Grondona P et al (2009) Simple cutaneous advancement flap anoplasty for resistant chronic anal fissure: a prospective study. World J Surg 33:1058–1063

    Article  PubMed  Google Scholar 

  • Goligher JC (1965) An evaluation of internal sphicterotomy and simple sphincter-stretching in the treatment of fissure-in- ano. Surg Clin North Am 45:1299–1304

    PubMed  CAS  Google Scholar 

  • Gupta PJ (2005) A study of suppurative pathologies associated with chronic anal fissures. Tech Coloproctol 9:104–107

    Article  PubMed  CAS  Google Scholar 

  • Gupta PJ, Kalaskar S (2003) Removal of hypertrophied anal papillae and fibrous anal polyp increases patient satisfaction after anal fissure surgery. Tech Coloproctol 155–158

    Google Scholar 

  • Hancke E, Rikas E, Suchan K et al (2010) Dermal flap coverage for chronic anal fissure: lower incidence of anal incontinence compared to lateral internal sphincterotomy after long- term follow-up. Dis Colon Rectum 53:1563–1568

    Article  PubMed  Google Scholar 

  • Jensen SL, Lund F, Nielsen OV et al (1984) Lateral subcutaneous sphincterotomy versus anal dilatation in the treatment of fissure in ano in outpatients: a prospective randomised study. Br Med J 289:528–530

    Article  CAS  Google Scholar 

  • Kang GS, Kim BS, Choi PS et al (2008) Evaluation of healing and complications after lateral internal sphincterotomy for chronic anal fissure: marginal suture of incision vs. open left incision: prospective, randomized, controlled study. Dis Colon Rectum 51:329–333

    Article  PubMed  Google Scholar 

  • Katsinelos P, Papaziogas B, Koutelidakis I et al (2006) Topical 0.5% nifedipine vs. lateral internal sphincterotomy for the treatment of chronic anal fissure: long-term follow-up. Int J Colorectal Dis 21:179–183

    Article  PubMed  Google Scholar 

  • Khubchandani IT, Reed JF (1989) Sequelae of internal sphincterotomy for chronic fissure in ano. Br J Surg 76:431–434

    Article  PubMed  CAS  Google Scholar 

  • Kiyak G, Korukluoglu B, Kuşdemir A et al (2009) Results of lateral internal sphincterotomy with open technique for chronic anal fissure: evaluation of complications, symptom relief, and incontinence with long-term follow-up. Dig Dis Sci 54:2220–2224

    Article  PubMed  Google Scholar 

  • Leong A (2005) Internal sphincterotomy versus rotation flap to treat chronic anal fissures. Asian J Surg 28:192

    Article  PubMed  Google Scholar 

  • Leong AF, Seow-Choen F (1995) Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure. Dis Colon Rectum 38:69–71

    Article  PubMed  CAS  Google Scholar 

  • Libertiny G, Knight JS, Farouk R (2002) Randomised trial of topical 0.2% glyceryl trinitrate and lateral internal sphincterotomy for the treatment of patients with chronic anal fissure: long-term follow-up. Eur J Surg 168:418–421

    Article  PubMed  Google Scholar 

  • Liratzopoulos N, Efremidou El, Papageorgiou MS et al (2006) Lateral subcutaneous internal sphincterotomy in the treatment of chronic anal fissure: our experience. J Gastrointestin Liver Dis 15:143–147

    PubMed  Google Scholar 

  • Lolli P, Malleo G, Rigotti G (2010) Treatment of chronic anal fissures and associated stenosis by autologous adipose tissue transplant: a pilot study. Dis Colon Rectum 53:460–466

    Article  PubMed  Google Scholar 

  • Lubowski D (2008) Topical therapy is first line treatment for chronic anal fissure because of the risk of incontinence with sphincterotomy. Dis Colon Rectum 51:1157–1158

    Article  PubMed  Google Scholar 

  • Lysy J, Israeli E, Levy S et al (2006) Long-term results of “chemical sphincterotomy” for chronic anal fissure: a prospective study. Dis Colon Rectum 49:858–864

    Article  PubMed  Google Scholar 

  • Maturanza M, Maritato F, Costanzo A et al (1997) Combined outpatient surgical-cryotherapeutic treatment of anal fissures. Our experience. Minerva Chir 52:393–395

    PubMed  CAS  Google Scholar 

  • McMurrick P, Polglase A, Binns K et al (2010) Prospective comparison of sphincterotomy vs Botox injection for anal fissure. ASCRS Meeting Abstracts, Dis Colon Rectum 53:588

    Google Scholar 

  • Mentes BB, Ege B, Leventoglu S et al (2005) Extent of lateral internal sphincterotomy: up to the dentate line or up to the fissure apex? Dis Colon Rectum 48:365–370

    Article  PubMed  Google Scholar 

  • Menteş BB, Güner MK, Leventoglu S et al (2008) Fine-tuning of the extent of lateral internal sphincterotomy: spasm-controlled vs. up to the fissure apex. Dis Colon Rectum 51:128–133.

    Article  PubMed  Google Scholar 

  • Menteş BB, Irkörücü O, Akin M et al (2003) Comparison of botulinum toxin injection and lateral internal sphincterotomy for the treatment of chronic anal fissure. Dis Colon Rectum 46:232–237

    Article  PubMed  Google Scholar 

  • Menteş BB, Tezcaner T, Yilmaz U et al (2006) Results of lateral internal sphincterotomy for chronic anal fissure with particular reference to quality of life. Dis Colon Rectum 49:1045–1051

    Article  PubMed  Google Scholar 

  • Miliacca C, Gagliardi G, Pescatori M (2010) The ‘Draw-the-Family Test’ in the preoperative assessment of patients with anorectal diseases and psychological distress: a prospective controlled study. Colorectal Dis 12:792–798

    Article  PubMed  CAS  Google Scholar 

  • Mishra R, Thomas S, Maan MS et al (2005) Topical nitroglycerin versus lateral internal sphincterotomy for chronic anal fissure: prospective, randomized trial. ANZ J Surg 75:1032–1035

    Article  PubMed  Google Scholar 

  • Mousavi SR, Sharifi M, Mehdikhah Z (2009) A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure. J Gastrointest Surg 13:1279–1282

    Article  PubMed  CAS  Google Scholar 

  • Nelson R (2005) Operative procedures for fissure in ano. Cochrane Database Syst Rev 18:CD002199

    Google Scholar 

  • Orsay C, Rakinic J, Perry WB et al (2004) Practice parameters for the management of anal fissures (revised). Dis Colon Rectum 47:2003–2007

    Article  PubMed  Google Scholar 

  • Ortiz H, Marzo J, Armendariz P et al (2005) Quality of life assessment in patients with chronic anal fissure after lateral internal sphincterotomy. Br J Surg. 92:881–885

    Article  PubMed  CAS  Google Scholar 

  • Pascual M, Parés D, Pera M et al (2008) Variation in clinical, manometric and endosonographic findings in anterior chronic anal fissure: a prospective study. Dig Dis Sci 53:21–26

    Article  PubMed  Google Scholar 

  • Patti R, Famà F, Barrera T et al (2010) Fissurectomy and anal advancement flap for anterior chronic anal fissure without hypertonia of the internal anal sphincter in females. Colorectal Dis 12:1127–1130

    Article  PubMed  CAS  Google Scholar 

  • Pelta AE, Davis KG, Armstrong DN (2007) Subcutaneous fissurotomy: a novel procedure for chronic fissure-in-ano. a review of 109 cases. Dis Colon Rectum 50:1662–1667

    Article  PubMed  Google Scholar 

  • Pérez-Miranda M, Robledo P, Alcalde M et al (1996) Endoscopic anal dilatation for fissure-in-ano: a new outpatient treatment modality. Rev Esp Enferm Dig 88:265–272

    PubMed  Google Scholar 

  • Pernikoff BJ, Eisenstat TE, Rubin RJ et al (1994) Reappraisal of partial lateral internal sphincterotomy. Dis Colon Rectum 37:1291–1295

    Article  PubMed  CAS  Google Scholar 

  • Perry WB, Dykes SL, Buie WD et al (2010) Practice parameters for the management of anal fissures (3rd revision). Dis Colon Rectum 53:1110–1115

    Article  PubMed  Google Scholar 

  • Pescatori M, Ayabaca SM, Cafaro D (2002) Tailored sphincterotomy or fissurectomy and anoplasty? Dis Colon Rectum 45:1563–1564

    Article  PubMed  Google Scholar 

  • Pescatori M, Interisano A, Basso L et al (1995) Management of perianal Crohn’s disease. Results of a multicenter study in Italy. Dis Colon Rectum 38:121–124

    Article  PubMed  CAS  Google Scholar 

  • Pescatori M, Maria G, Anastasio G (1991) “Spasm related ” internal sphincterotomy in the treatment of anal fissure. Coloproctology 13:20–22

    Google Scholar 

  • Pescatori M, Mattana C (2008) Fissures. In: Herold A, Lehur PA, Matzel KE, O’Connell PR (eds) Coloproctology. Springer, pp 45–51

    Google Scholar 

  • Poisson J (1997) Anal fissure. Can J Surg 20:417–421

    Google Scholar 

  • Ram E, Alper D, Stein GY et al (2005) Internal anal sphincter function following lateral internal sphincterotomy for anal fissure: a long-term manometric study. Ann Surg 242:208–211

    Article  PubMed  Google Scholar 

  • Renzi A, Brusciano L, Pescatori M et al (2005) Pneumatic balloon dilatation for chronic anal fissure: a prospective, clinical, endosonographic, and manometric study. Dis Colon Rectum 48:121–126

    Article  PubMed  CAS  Google Scholar 

  • Renzi A, Izzo D, Di Sarno G et al (2008) Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial. Dis Colon Rectum 51:121–127

    Article  PubMed  Google Scholar 

  • Rosa G, Lolli P, Piccinelli D et al (2005) Calibrated lateral internal sphincterotomy for chronic anal fissure. Tech Coloproctol. 9:127–131

    Article  PubMed  CAS  Google Scholar 

  • Saad AM, Omer A (1992) Surgical treatment of chronic fissure in ano: a prospective randomized study. East Afr Med J 69:613–615

    PubMed  CAS  Google Scholar 

  • Sajid MS, Vijaynagar B, Desai M et al (2008) Botulinum toxin vs glyceryltrinitrate for the medical management of chronic anal fissure: a meta-analysis. Colorectal Dis 10:541–546

    Article  PubMed  CAS  Google Scholar 

  • Simkovic D, Smejkal K, Hladík P (2000) Assessment of sphincterotomy results in patients treated for anal fissure. Rev Esp Enferm Dig 92:399–404

    PubMed  CAS  Google Scholar 

  • Speakman CT, Burnett SJ, Kamm MA et al (1991) Sphincterinjury after anal dilatation demonstrated by anal endosonography. Br J Surg 78:1429–1430

    Article  PubMed  CAS  Google Scholar 

  • Srinivasaiah N, Laden G, Duthie GS et al (2008) The long-term efficacy of fissurectomy and botulinum toxin injection for chronic anal fissure in females. Dis Colon Rectum 51:1589

    Article  PubMed  CAS  Google Scholar 

  • Usatoff V, Polglase AL (1995) The longer term results of internal anal sphincterotomy for anal fissure. Aust N Z J Surg 65:576–578

    Article  PubMed  CAS  Google Scholar 

  • Vafai M, Mann CV (1981) Closed lateral internal anal sphincterotomy without removal of sentinel pile for fissure-in-ano. Coloproctology 3:91–93

    Google Scholar 

  • Walfisch S, Silberstein E (1998) Balloon anal dilatation for anal fissure. Tech Coloproctol 2:73–75

    Google Scholar 

  • Wiley M, Day P, Rieger N et al (2004) Open vs. closed lateral internal sphincterotomy for idiopathic fissure-in-ano: a prospective, randomized, controlled trial. Dis Colon Rectum 47:847–852

    Article  PubMed  CAS  Google Scholar 

  • Yucel T, Gonullu D, Oncu M et al (2009) Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective, randomized study. Int J Surg 7:228–231

    Article  PubMed  Google Scholar 

  • Zbar AP, Pescatori M (2004) Functional outcome following lateral internal anal sphincterotomy for chronic anal fissure. Colorectal Dis 6:210–211

    Article  PubMed  CAS  Google Scholar 

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  1. Unità di Colonproctologia, Casa di Cura Ars Medica e Università La Sapienza, Roma

    Mario Pescatori

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Pescatori, M. (2011). Ragade anale. In: Prevenzione e trattamento delle complicanze in chirurgia proctologica. Springer, Milano. https://doi.org/10.1007/978-88-470-2062-7_1

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