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Erschienen in:
01.04.2011
Mucosal Advancement Flap Anoplasty for Chronic Anal Fissure Resistant to Conservative Therapy
Erschienen in: World Journal of Surgery | Ausgabe 4/2011
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Background
Sphincter-sparing procedures are increasingly advocated in the treatment of chronic anal fissures (CAF) resistant to conservative management. Herein, we report about our results with sphincter-sparing transanal mucosal advancement flap anoplasty (MAAP) to treat CAF.
Patients and Methods
The present study was a retrospective single-center analysis of patients in whom conservative management of CAF failed and who subsequently underwent MAAP between January 2003 and December 2008.
Results
A total of 26 patients with a median age of 46.5 years (range: 17–79 years) had undergone MAAP after suffering with CAF for a median period of 9 months (range: 4–36 months). Surgery was well tolerated in all patients. One patient developed a perianal abscess at the operative site 3 weeks after MAAP, which required excision. At 2, 12, and 24 months follow-up, all patients were free of pain with no fissure recurrence or any worsening of incontinence.
Conclusions
Mucosal advancement flap anoplasty might be another sphincter-sparing treatment option in patients suffering from CAF. To draw final conclusions about the value of MAAP in the treatment of CAF, more solid data are required.