Abstract
The study compared symptoms and manometric results in 76 patients (42 men and 34 women; median age: 45 years) before and at long-term follow-up (median time: 54 months) after fissurectomy with posterior midline sphincterotomy for anal fissure. The fissure healed in all cases. Sporadic loss of continence for flatus or for liquid stool occurred in 21 patients (27.6%) and soiling was present in 7 other patients (9.2%). Preoperative maximum resting anal pressure was significantly greater in the study group compared with 40 control subjects (p<0.001). Postoperative resting anal pressure fell significantly (p<0.001) and remained low on long-term assessment. Postoperative maximal squeeze pressure remained unchanged. No correlation could be found between preoperative and postoperative clinical symptoms (including continence) and anorectal manometry.
Résumé
Cette étude compare les symptomes et les résultats manométriques de 76 patients (42 hommes et 34 femmes; âge moyen 45 ans) avant et longtemps après (recul moyen 54 mois) une fissurectomie avec sphinctérotomie médiane postérieure pour fissure anale. La cicatrisation de la fissure fût obtenue dans tous les cas. Une perte de continence sporadique pour les gaz ou pour les matières lipuides est survenue chez 21 malades (27.6%) et un suintement a été présent chez 7 autres (9.2%). La pression anale maximale de repos avant l'opération était significativement plus grande. Ces malades ont été comparés avec un groupe contrôle de 40 sujets (p<0.001). Après l'opération la pression anale de repos diminuait significativement (p<0.001) et demeurait plus basse à long terme. La pression de retenue maximale post-opératoire demeurait inchangée. Aucune corrélation n'a pû être trouvée entre les symptomes cliniques pré et post-opératoires (incluant la continence) et la manométrie ano-rectale.
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Melange, M., Colin, J.F., Van Wymersch, T. et al. Anal fissure: correlation between symptoms and manometry before and after surgery. Int J Colorect Dis 7, 108–111 (1992). https://doi.org/10.1007/BF00341296
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DOI: https://doi.org/10.1007/BF00341296