经内外括约肌间肛门内括约肌侧切术在治疗慢性肛裂中的应用

Intersphincteric lateral internal sphincterotomy technique for chronic anal fissure

目的探索经内外括约肌间肛门内括约肌侧切术(ILIS)治疗慢性肛裂的疗效。方法对2018年2—6月宁波大学医学院附属医院25例慢性肛裂患者采用经内外括约肌间肛门内括约肌侧切术治疗,分析其愈合时间、术后1、3、5 d疼痛评分、Wexner评分和肛门直肠压力,评价此手术的有效性。结果所有患者均手术顺利,其中24例患者慢性肛裂手术切口Ⅰ级愈合,愈合时间为(14.66±5.63)d,1例患者为Ⅱ级愈合,术后1、3和5 d疼痛评分分别为(2.32±0.82)、(1.66±0.74)和(1.22±0.63)分,没有患者发生肛门失禁,肛门失禁评分为0分。结论经内外括约肌间肛门内括约肌侧切术是治疗慢性肛裂的一种微创、疼痛轻、安全有效的手术方式。

Objective To describe a new technique for chronic anal fissure surgery aimed at minimal invasion and reducing pain,and to evaluate the preliminary results concerning non-healing and intact anal function.Methods A prospective observational study in twenty-five chronic anal fissure patients treated by Intersphincteric Lateral Internal Sphincterotomy(ILIS)technique from February to June 2018 in the Affiliated Hospital of Medical School of Ningbo University were conducted.Results Chronic anal fissure in twenty-five patients healed primarily(96%,24/25).There was one non-healing case.The mean healing time was(14.66±5.63)d.Pain scores of 1,3 and 5 d after surgery were(2.32±0.82),(1.66±0.74),(1.22±0.63)scores.None had disturbance in clinical anal continence.Wexner score was 0.Conclusions The early outcome of the ILIS technique is quite impressive.This technique is minimally invasive,with shorter healing time and less pain.It has the potential to become a viable option for chronic anal fissure surgery.