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348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI

Yıl 2004, Cilt: 10 Sayı: 3, 121 - 124, 01.09.2004

Öz

1998-2004 yılları arasında kronik anal fissürlü 348 hastanın cerrahi tedavi sonuçları incelendi. Hastalarımızın 22'sine anal dilatasyon, 76'sına fissürektomi, 250'sine lateral internal sfinkterotomi uygulandı. Ameliyat sonrası dönemde 12 %3.4 hastada ciddi olmayan kanama, 8 %2.2 hastada idrar retansiyonu görüldü. Anal dilatasyon yapılan 5 %22.7 hastada, lateral internal sfinkterotomi yapılan 11 %4.4 hastada geçici inkontinans görüldü. Anal dilatasyon yapılan hastalarda %27.2, fissürektomi yapılan hastalarda %14.4, lateral internal sfinkterotomi yapılan hastalarda %1.6 nüks görüldü. Bu sonuçlar literatürde yer alan çalışmalara uymaktadır ve lateral internal sfinkterotomi kronik anal fissürün cerrahi tedavisinde seçkin yöntemdir

Kaynakça

  • Eisenhammer, S. The surgical correction of choronic internal anal (sphincter) contracture. S Afr Med J 1951; 25: 486
  • PhılipHuber, JR &Clifford L.Sımmang. Fissure-İn_Ano. Shackelford's Surgery Alimentary Tract. 2002; 4: (27): 383-87
  • Lund JN, Scholefield JH. Aetioloji and treatmant of anal fissure.Br J Surg 1996; 83: 1335-44
  • Klosterhalfen B,Vogel P,Rixen H,Mittermayer C.Topography of the inferior rectal artery: A possible cause of chronic,primary anal fissure. Dis Colon Rectum 1989; 32: 43-52
  • AbcarianH:Surgical correction of choronic anal fissure:Results of lateral internal sphincterotomy vs.fissurectomy-middline sphincterotomy. Dis. Colon Rectum, 1980; 23: 31
  • Eisenhammer,S.: The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure.Surg. Gynecol. Obstet., 1959; 109: 583
  • Gordon PH: Fissure-İn_Ano:Gordon PH,Nivo-atvongs S (Eds).Principles and Practice of Surgery for the Colon,Rectum and Anüs.2nd Ed. p.217-241, Qualty Medical Publishing, Inc St Louis, Missouri, 1999.
  • Lund JN,Binch C,Mc Grath J,et al.Topographical distribution of blood suuply to the anal canal. Br J Surg 1999; 110: 711-4
  • Schouten, W.R., Briel, J.W., and Auwerda, J.J.D.: Relationship between anal pressure and anodermal blood flow- The vascular pathogenesis of anal fissure.Dis Colon Rectum, 1994; 37: 66
  • Schouten, W.R., Briel,J.W., Auwerda, J.J.A., and DeGraaf, E.J.R.: Ischaemic nature of anal fissure. Br.J. Surg., 1996; 83: 63
  • Mc Namara MI,Perey JP,: A manometric study of anal fissure treated by subcutaneus lateral sphincterotomy, Ann Surg 1990; : 235-238
  • N. Sökücü. Anal Fissür. Kolon Rectum ve Anal Bölge Hastalıkları.2003 s.163-169
  • Watson SJ, Kamm MA, Nichols RJ, Philips RK.Topical glyceryl trinitrat in the treatment of choronic anal fissure. Br J Surg 1996; : 771-5.
  • Lund JN, Armitage NC, Scholofield JH.Use of gliceryl trinitrate oinment in the treatment of the choronic anal fssure. Br J Surg : 83; 776-7
  • Lysy J, Yatzkan BS, et al. Treatment of anal fissure with isosorbite dinitrate. Dis Colon Rectum 1998; 1407-10
  • Brisinda G, Maria G, Bentivoglio AR, et al.A comprasion of injections of botulinum toxin and topical nitroglycerin oinment for the treatmant of chronic anal fissure Gorfine, S. R.: Treatment of benign anal disease with topical nitro glycerin.Dis. Colon Rectum. 1995; 38: 453
  • Minquez M, Melo F, et al. Therapeutic effectsof different doses of botulinum toxin in chronic anal fissure.Dis Colon Rectum ; 42: 1016-21
  • Jost VH.: One hundred cases of anal fissure with botulin toxin early and long term results.Dis Colon Rectum, 1997; 40: 1029
  • Maria G, Cassetta E, Gui D, et al. A comprasion of botulinum toxin and saline for the treatment of chronic anal fissure. N.Engl.J.Med., 1998; 338: 217
  • Jonas M, Spake W, Schofield JH. Diltiazem heals glyceryl trinitrate-resistant chronic anal fissure. Dis Colon Rectum 2002; 45: 5
  • Sohn N, Eisenberg M.M, Weinstein M.A., et al. Precise anorectal sphincter dilatation: İts role ofin the tehraphy of anal fissure. Dis Colon Rectum, 1992; 35: 322
  • Keighley MRB, Wiliams NS. Fissure-in-Ano.İn: Keighley MRB,Wiliams NS (Eds).Surgery of the Anus,Rectum and Colon. 2end Ed. p.428-56, W.B. Saunders Company Limited, London, 1999
  • Nyan DCNK, Wilson KG, Steawart KJ, et al.Island advancement flaps in the management of anal fissures. Br J Surg 1995; 82: 8.
  • Arnell TD. and Stamos M.J:Sphincterotomy for anal fissure. Semin. Colon Rectal Surgery. 1997; 8: 24
  • Nyan DC, Pemberton JH. Long therm results of lateral internal sphincterotomy for choronic anal fissure with particular reference to incidence of fecal incontinence. Dis Colon Rectum.1999; 42: 1306-10.
  • Nelson RL. Meta-analysis of operative techniques for fissure-in-ano.Dis Colon Rectum. 1999; 42: 1424-31.
  • Evans J, Luck A, Hewett P. Glyceryl trinitrate vs. lateral sphincterotomy for chronic anal fissure.Dis Colon Rectum 2001; 44: 93

TREATMENT AND RESULTS OF 348 CHRNIC ANAL FISSURE CASES

Yıl 2004, Cilt: 10 Sayı: 3, 121 - 124, 01.09.2004

Öz

In this article the result of surgery treatment of 348 patient with chronic anal fissure between 1998-2004 are reported. Anal dilatation, fissurectomy and lateral internal sphincterotomy was performed for 22, 76 and 250 patients respectively. In the postoperative period nonserious bleeding was found in 12 %3.4 patients. Urinery retansion was occured in 8 % 2.2 patients.Temporary incontinence was occured in 5 %22.7 patients treated with anal dilatation and 11 %4.4 patients treated with lateral internal sphincterotomy . Recurrence of anal fissure were seen in 6 %27.2 patients treated with dilatation, in 11 %14.4 patients treated fissurectomy and in 4 %1.6 patients treated with lateral internal sphincterotomy. Our results support the findings of other studies in the literature. In conclusion lateral internal sphincterotomy operation is avaluable choice in treatment of chronic anal fissure

Kaynakça

  • Eisenhammer, S. The surgical correction of choronic internal anal (sphincter) contracture. S Afr Med J 1951; 25: 486
  • PhılipHuber, JR &Clifford L.Sımmang. Fissure-İn_Ano. Shackelford's Surgery Alimentary Tract. 2002; 4: (27): 383-87
  • Lund JN, Scholefield JH. Aetioloji and treatmant of anal fissure.Br J Surg 1996; 83: 1335-44
  • Klosterhalfen B,Vogel P,Rixen H,Mittermayer C.Topography of the inferior rectal artery: A possible cause of chronic,primary anal fissure. Dis Colon Rectum 1989; 32: 43-52
  • AbcarianH:Surgical correction of choronic anal fissure:Results of lateral internal sphincterotomy vs.fissurectomy-middline sphincterotomy. Dis. Colon Rectum, 1980; 23: 31
  • Eisenhammer,S.: The evaluation of the internal anal sphincterotomy operation with special reference to anal fissure.Surg. Gynecol. Obstet., 1959; 109: 583
  • Gordon PH: Fissure-İn_Ano:Gordon PH,Nivo-atvongs S (Eds).Principles and Practice of Surgery for the Colon,Rectum and Anüs.2nd Ed. p.217-241, Qualty Medical Publishing, Inc St Louis, Missouri, 1999.
  • Lund JN,Binch C,Mc Grath J,et al.Topographical distribution of blood suuply to the anal canal. Br J Surg 1999; 110: 711-4
  • Schouten, W.R., Briel, J.W., and Auwerda, J.J.D.: Relationship between anal pressure and anodermal blood flow- The vascular pathogenesis of anal fissure.Dis Colon Rectum, 1994; 37: 66
  • Schouten, W.R., Briel,J.W., Auwerda, J.J.A., and DeGraaf, E.J.R.: Ischaemic nature of anal fissure. Br.J. Surg., 1996; 83: 63
  • Mc Namara MI,Perey JP,: A manometric study of anal fissure treated by subcutaneus lateral sphincterotomy, Ann Surg 1990; : 235-238
  • N. Sökücü. Anal Fissür. Kolon Rectum ve Anal Bölge Hastalıkları.2003 s.163-169
  • Watson SJ, Kamm MA, Nichols RJ, Philips RK.Topical glyceryl trinitrat in the treatment of choronic anal fissure. Br J Surg 1996; : 771-5.
  • Lund JN, Armitage NC, Scholofield JH.Use of gliceryl trinitrate oinment in the treatment of the choronic anal fssure. Br J Surg : 83; 776-7
  • Lysy J, Yatzkan BS, et al. Treatment of anal fissure with isosorbite dinitrate. Dis Colon Rectum 1998; 1407-10
  • Brisinda G, Maria G, Bentivoglio AR, et al.A comprasion of injections of botulinum toxin and topical nitroglycerin oinment for the treatmant of chronic anal fissure Gorfine, S. R.: Treatment of benign anal disease with topical nitro glycerin.Dis. Colon Rectum. 1995; 38: 453
  • Minquez M, Melo F, et al. Therapeutic effectsof different doses of botulinum toxin in chronic anal fissure.Dis Colon Rectum ; 42: 1016-21
  • Jost VH.: One hundred cases of anal fissure with botulin toxin early and long term results.Dis Colon Rectum, 1997; 40: 1029
  • Maria G, Cassetta E, Gui D, et al. A comprasion of botulinum toxin and saline for the treatment of chronic anal fissure. N.Engl.J.Med., 1998; 338: 217
  • Jonas M, Spake W, Schofield JH. Diltiazem heals glyceryl trinitrate-resistant chronic anal fissure. Dis Colon Rectum 2002; 45: 5
  • Sohn N, Eisenberg M.M, Weinstein M.A., et al. Precise anorectal sphincter dilatation: İts role ofin the tehraphy of anal fissure. Dis Colon Rectum, 1992; 35: 322
  • Keighley MRB, Wiliams NS. Fissure-in-Ano.İn: Keighley MRB,Wiliams NS (Eds).Surgery of the Anus,Rectum and Colon. 2end Ed. p.428-56, W.B. Saunders Company Limited, London, 1999
  • Nyan DCNK, Wilson KG, Steawart KJ, et al.Island advancement flaps in the management of anal fissures. Br J Surg 1995; 82: 8.
  • Arnell TD. and Stamos M.J:Sphincterotomy for anal fissure. Semin. Colon Rectal Surgery. 1997; 8: 24
  • Nyan DC, Pemberton JH. Long therm results of lateral internal sphincterotomy for choronic anal fissure with particular reference to incidence of fecal incontinence. Dis Colon Rectum.1999; 42: 1306-10.
  • Nelson RL. Meta-analysis of operative techniques for fissure-in-ano.Dis Colon Rectum. 1999; 42: 1424-31.
  • Evans J, Luck A, Hewett P. Glyceryl trinitrate vs. lateral sphincterotomy for chronic anal fissure.Dis Colon Rectum 2001; 44: 93
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Enver İlhan Bu kişi benim

Mehmet Yıldırım Bu kişi benim

Alper Fırat Polat Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2004
Yayımlandığı Sayı Yıl 2004 Cilt: 10 Sayı: 3

Kaynak Göster

APA İlhan, E., Yıldırım, M., & Polat, A. F. (2004). 348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI. İzmir Eğitim Ve Araştırma Hastanesi Tıp Dergisi, 10(3), 121-124.
AMA İlhan E, Yıldırım M, Polat AF. 348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI. İzmir EAH Tıp Der. Eylül 2004;10(3):121-124.
Chicago İlhan, Enver, Mehmet Yıldırım, ve Alper Fırat Polat. “348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI”. İzmir Eğitim Ve Araştırma Hastanesi Tıp Dergisi 10, sy. 3 (Eylül 2004): 121-24.
EndNote İlhan E, Yıldırım M, Polat AF (01 Eylül 2004) 348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi 10 3 121–124.
IEEE E. İlhan, M. Yıldırım, ve A. F. Polat, “348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI”, İzmir EAH Tıp Der, c. 10, sy. 3, ss. 121–124, 2004.
ISNAD İlhan, Enver vd. “348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI”. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi 10/3 (Eylül 2004), 121-124.
JAMA İlhan E, Yıldırım M, Polat AF. 348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI. İzmir EAH Tıp Der. 2004;10:121–124.
MLA İlhan, Enver vd. “348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI”. İzmir Eğitim Ve Araştırma Hastanesi Tıp Dergisi, c. 10, sy. 3, 2004, ss. 121-4.
Vancouver İlhan E, Yıldırım M, Polat AF. 348 KRONİK ANAL FİSSÜR OLGULARININ TEDAVİ VE SONUÇLARI. İzmir EAH Tıp Der. 2004;10(3):121-4.