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Five‐year results of fissurectomy for chronic anal fissure : low recurrence rate and minimal effect on continence
Author(s) -
Schornagel I. L.,
Witvliet M.,
Engel A. F.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02840.x
Subject(s) - medicine , surgery , patient satisfaction , anal fissure , conservative treatment
Aim The aim of the study was to determine the long‐term outcome, recurrence rate and faecal incontinence score after fissurectomy for chronic anal fissure (CAF) not responding to conservative treatment. Method Fifty‐three consecutive patients (29 women) who underwent fissurectomy for a medically resistant CAF between 1998 and 2005 were included in the study. At a minimum follow‐up of 5 years a standardized questionnaire was sent to all patients, assessing recurrence, satisfaction with the operation (on a scale of 0–10) and faecal continence (Vaizey score, 0–24). The patients were compared with a control group of 50 healthy volunteers, matched for sex and age, who had never undergone anal surgery. Results Forty‐three (81%) patients (25 women) returned the questionnaire. The mean age was 40 (SD 12.1) years and median follow up was 8.2 (5.5–12.2) years. Five patients had a recurrent CAF (11.6%). Ninety per cent of patients would have consented to the operation again if necessary. The mean Vaizey score at follow‐up was 2.5 (SD ± 4.2). The mean Vaizey score of the four patients who had had a previous lateral sphincterotomy was 3.8 and for the eight patients who had reported a continence disturbance before fissurectomy it was 8.3. The mean Vaizey score of the 31 patients who were continent before fissurectomy was 0.8 compared with 0.4 in the control group ( P = 0.9). Conclusion At 5 years or more fissurectomy for medically resistant CAF is effective with a low recurrence rate and minimal influence on continence.