Anal fissure surgery

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The name of the condition comes from the clinical picture related to ulcers, and is not related to its appearance. The anal fissure is fissure-shaped only when the anal muscles are tensed. It usually runs from the pectineal line to the anal verge. In 75% to 90% of the cases it is located at the posterior commissure and in the remaining cases it is located at the anterior commissure or, more rarely, in lateral parts. The anal fissure may be acute (occurring suddenly during bowel movement) or chronic (resulting from a superinfection and chronic inflammation).
Main clinical symptoms include: sharp pain in the anal canal during defecation, lasting for up to 30 minutes after bowel movement, bright red blood on stool or on toilet paper, itchiness, discharge from the anus.
Possible conservative treatments include:

  • medications to decrease the frequency and intensity of constipations,
  •  medications to decrease the tension of the internal anal sphincter,
  • botulinum toxin,
  • calcium channel blockers.

If conservative treatment is not effective, then surgical treatment (lateral sphincterotomy) is necessary. In this procedure the internal anal sphincter is partially divided and the fissure is removed. Specimens are collected and sent for histopathological examination.

Eligibility for the procedure:

The decision on your surgery is taken during a pre-operative visit when a doctor assesses your eligibility, selects the optimum procedure and orders necessary tests. The decision on the procedure is taken on the basis of the evaluation of the patient’s test results and general condition. Then, a convenient date of the surgery is selected.

Before the procedure:

  • One week before the procedure you should have the following tests done: full blood count, electrolyte test, coagulation test, blood type, glucose, creatinine, Hbs antigen, ANTI-HCV.
  • If you have other medical conditions, please consult your attending doctors and bring a certificate that there are no contraindications to the surgical procedure.
  • If you are on anticoagulant treatment, you should switch to subcutaneous medications 7 days before the procedure.
  • Consult with the attending doctor whether to take any medications on the day of the procedure.
  • On the day of the surgery you should come to hospital on an empty stomach.

Procedure:

  • the procedure is performed under spinal block,
  • it lasts for up to 20 minutes.

After the procedure:

After anal fissure surgery you can return to normal activity on the day after the procedure, but you should follow these guidelines:

  • Physical exercise should be limited for up to one week after the surgery.
  • You should avoid constipation and sedentary lifestyle.
  • The wound should be rinsed with Octenisept solution every day.
  • Histopathology results should be collected 14 days after the surgery.

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Wielkopolskie Centrum Medyczne
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