经皮侧方内括约肌部分切断术治疗陈旧性肛裂

LATERNAL SUBATONEOUS PARTIAL INTERNAL SPHINCTEROTOMY FOR CHRONIC ANAL FISSURE

目的 :评估侧方内括约肌切断术治疗慢性肛裂的效果及合理性。方法 :回顾性分析在 1985～ 2 0 0 0年 14 0例患有慢性肛裂并施行侧方内括约肌切断术 (L IS)的疗效。结果 :在切断内括肌的 1.0～ 1.5 cm范围内 ,L IS的长度相关于治疗效果。并发症有切口血肿 16例 ;医原性肛瘘 4例 ;内痔脱出嵌顿 3例 ;暂时性大便失禁 11例。结论 :经过长期的随访后发现 ,L

Objective:To evaluate the effect and responsle of LIS.Methods:From 1985 to 2000,140 patients who were affectde with CAF and accepted LIS were retrospectively analyzed.Lateral (9 o'clock position) internal sphincterotomy was carried out by using an open or subcutaneous technique and under local anesthesia,aiming to break this vicious cycle to reduce the maximum resting anal pressure (MRAP) by disrupting the internal anal sphincter under dental alular.Results:The length of LIS is correlatied to the effect of the treatment from 1.0 cm to 1.5 cm.The complications of LIS were incision hemorrhage swelling in 16 cases,iatrogenic fistulas in 4 cases,internal hemorrhoids prolapsed inchase in 3 cases,temporary fecal incontinence in 11 cases.The others were cured within two weeks.Conclusion:LIS appears to be a well tolerated and effeetive method for CAF after long-term follow-up.