The Clinical Study Of Four Methods Of Treatment Of Anal Fissure (with 240 Clinical Cases),

ObjectiveThere are more than eighty methods to cure anal fissure at pressent,of them,32 kinds of operative mode, there was no a kind of authentic and useful methods.Then division of internal sphincterotomy becomes a univeral method in the world,now we will make more progress for the purpose of the discussion on the best operative mode.The 4 main kinds of operation for annal fissure in our hospital were observed and studied, found out its advantages and disadvantages, for the benefit of clinical reference.Materials and MethodsA retrospective review of 240 patients with anal fissure and in-patients from 2002.09-2004.12 , hospital of traditional Chinese medicine (TCM) , in hubei Province .The 4 main kinds of opertive modes:Division of internal sphincterotomy of the anal canal in the jijian-gap(A team), post-median anal incision and dilatation(B team), the lateral partial division of internal sphincterotomy(C team), the lateral partial division of internal sphincter and suturing (D team), in 240 cases, male 81 cases, female 159 cases,24 male patients and 36 females patients in A group, the disease was commonly seen in people at the age of 15-64, the average age of 36± 12.8,the disease course of 0.5-30 years, the average year of 3.2±2.8 ; 20 male patients and 40 female patients in B group, the disease was commonly seen in people at the age of 20-60, the average age of 37±14.3, the disease course of 0.3-25 years, the average year of 3.0±2.5; 16 male patients and 44 female patients in C group, the disease was commonly seen in people at the age of 19-69, the average age of 37± 12.9, the disease course of 0.5-20 years, the average year of 3.7±2.8; 21 male patients and 39 female patients in D group, the disease was commonly seen in people at the age of 22-64, the average age of 38±13.7, the disease course of 0.3-10 years, the average year of 3.4±2.5; Comparison its between male and female,age ,the disease course, complication,the position of the anal canal,etc.There wasn't significant difference (P>0.05) . Statisic test was used to the average healing time ,healing rate, complication and the recurrence rate.ResultsWe are usually think the average healing time as the criteria of the clinical healing.Of them,A group is five days on its shortest healing time and twenty days on longest. B group is 15 days on its shortest healing time and 34 days on longest. C group is 10 days on its shortest healing time and twenty days on longest. D group is 10 days on its shortest healing time and 15 days on longest.In terms of complication,A group and C group are four cases respectively,B group and D group are one case respectively.Q test was used to complication comperative, There wasn't significant difference (P>0.05) .The healing rate of the anal fissure: A group and C group has two cases about the probability of post-operative anal incontinence of gas and liquid, and no anal incontinence occurred after the healing ,has two cases hematomata and infections.The results show that the healing rate is similar between A group(76.67%) and C group(83.33%) ,between B group(90.00%) and D group(93.33%).X2 test was used to provide ,there were no obvious difference (P>0.05 ) .While the results between A C group and B D group were obvious difference (P<0.05).ConclusionDivision of internal sphincter of the anal canal in the jijian-gap(A team): the procedure is mainly excise the internal sphincter, dispelling the spasm of the internal sphincter,improving the partial blood circulation,improving the healing rate of chronic anal fissure . The clinical materials show that the procedure has shorter healing time,whereas it is easier to form abscess and hematomata. So I think the procedure has such problems:(1)The patient of chronic anal fissure have some complications,when we cure these complications,increasing more cicatrization.(2) The procedure has still no effected rate, the materials is 3.33%.(3) The procedure has also the recurrence rate,is 3.33%.(4) The reasonable division of internal sphincter is the most important factor.It is an effective...