Clincial Study Of Lateral Anal Dilatation Combined With Modified Longitudinally Section Transverse Suture Operation In The Treatment Of Chronic Anal Fissure

Objective: Chronic anal fissure is one of the common diseases in anrectal surgery,which usually requires surgical treatment.There are significant differences in clinical efficacy and safety among different surgical procedures.Postoperative recovery,postoperative pain,recurrence,fecal incontinence and other related complications are considered when surgeons choose surgical methods.In order to solve the above problems better and promote patients to achieve ideal treatment effect,we improved the surgical methods and carried out clinical research in order to examine the efficacy and safety of lateral anal dilatation combined with modified longitudinally section transverse suture operation in the treatment of chronic anal fissure.Methods: Patients suffered chronic anal fissure were included and followed up in this retrospective analysis.The patients were divided into three groups according to different surgical methods: lateral anal dilatation combined with modified longitudinally section transverse suture operation(Group A),traditional anal dilatation combined with fissurectomy(Group B),lateral partial internal sphincterotomy combined with fissurectomy(Group C).General clinical data,operation time,postoperative hospital stay and medical expenses were collected.The postoperative pain,time to resume working,patient satisfaction score and complications within 6 months postoperatively,recrudescence,wound healing were followed up and compared,in order to analyze the differences in clinical efficacy and safety.Results: 1.There were no significant differences among the three groups on the operation time and medical expenses(P>0.05).The postoperative hospital stay in Group A was significantly longer than Group B(P<0.05).There was no significant difference between Group A and Group C in the postoperative hospital stay(P>0.05).The incidence of postoperatively pain in Group A was significantly lower than Group B(P<0.05).There was no significant difference between Group A and Group C in the incidence of postoperatively pain(P>0.05).2.The proportion of patients resuming work in Group A was significantly higher than Group B and Group C during 2 weeks postoperatively(P<0.05).3.The satisfaction score in Group A was significantly higher than Group B and Group C(P<0.05).4.There were no significant differences among the three groups on complications rate within 6 months postoperatively(P>0.05).The total complications rates in Group B(44.44%)and Group C(35.00%)were higher than Group A(17.39%).5.The incidence of postoperative fecal incontinence was 11.11% in Group B,and 5.00% in Group C.6.Only one case relapsed and one case healed poorly in Group B.Conclusions: The lateral anal dilatation combined with modified longitudinally section transverse suture operation in the treatment of chronic anal fissure showed quick postoperative recovery,high satisfaction score and low complications rate,compared with traditional anal diliation or lateral internal sphincter resection combined with fissurectomy.