Operation

• Anal fissures that show no response to non-surgical treatment.
• Patients at risk of incontinence due to a weak anal sphincter anal sphincter :

– Elderly/elderly patients
– Diabetes patients
– Patients suffering from irritable bowel syndrome
– Women with more than one vaginal delivery or traumatic vaginal deliveries

• Patients who have already undergone several surgical treatments for anal fissures.

A chronic fissure is a non-healing wound in the anal canal that has been present for weeks or months.

During a fissurectomy, the wound edges and base of the wound are excised and scraped, so that the wound can granulate from the bottom up on a healthy wound base.

Anoplasty : A flap of healthy tissue at the edge of the fissure is mobilized to cover the wound of the excised anal fissure.

• The surgical procedure is performed under general or local anesthesia.
• The surgical procedure takes about 30 minutes.
• The surgical procedure is performed in day hospital.
• The fissure heals in 85% of cases.

Infection

• Incidence : < 1%

Hematoma

• Incidence : < 1%

Risk of incontinence

• Incidence : < 1%

Recurrent anal fissure

• Incidence : +/- 15% – 20%

stewart et al: Clinical Practice Guideline for anal fissure management n for the ASCRS

Normal symptoms

• Anal pain is normal but should subside over time.
• Seepage of serous (yellowish) anal fluid.
• Fluid loss may be bloody but should subside over time.

Abnormal symptoms

Contact your surgeon or GP, or go to the emergency room:

• If pain increases over time.
• If fever does not subside over time.
• If pus volume increases or foul smelling viscous fluid increases.
• If blood loss persists.

If certain symptoms seem abnormal to you contact your doctor.

If this is not possible, you can contact avec your surgeon.

If you are unable to contact your GP or your surgeon, go to the emergency department at St Elizabeth Hospital in Uccle.

Incontinence

The risk of incontinence is minimal, even in patients with a weak anal sphincter.