Clinical effect evaluation of closed lateral internal sphincterotomy through intersphincteric approach in patients with chronic anal fissure and its pathogenic characteristics
QIN Qin1 DONG Qingjun2 WANG Chen2
1.Institute of Traditional Chinese Medicine Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;
2.Department of Anorectal, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Abstract：Objective To evaluate the clinical effect of closed internal sphincter sphincterotomy through intersphincter approach for the treatment of old anal fissure and its pathogenic characteristics. Methods Eighty-three patients with old anal fissure admitted to the Department of Anorectal, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to December 2020 were selected and divided into treatment group (34 cases) and control group (49 cases) according to the surgical methods. The treatment group was treated with closed internal sphincterotomy through intersphincteric approach, while the control group was treated with anal fissure incision and expansion. The clinical effect, healing time, pain and bleeding at the third day after surgery, intraoperative blood loss, operation time, hospitalization cost, hospitalization time, and abnormal anal function and recurrence at three months after discharge of the two groups were analyzed, and the pathogenic characteristics of old anal fissure were summarized. Results The results of this study showed that most of the old anal fissure consisted of single fissure, which was mainly located at the six o’clock position. Most of the clinical symptoms were pain and bleeding, and most of the complications were sentinel hemorrhoids. Both groups were cured, and there was no abnormal anal function or recurrence at three months after operation. There were no significant differences in intraoperative blood lose, hospitalization cost, and hospitalization time between the two groups (P＞0.05). The pain and bleeding at the third day after surgery in the treatment group were less than those in the control group, the healing time was shorter than that in the control group, and the operation time was longer than that in the control group, the differences were statistically significant (P＜0.05). Conclusion Closed internal sphincterotomy through intersphincter approach for the treatment of patients with old anal fissure is effective, can accelerate postoperative rehabilitation, worthy of application and promotion.
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