Advancement flap in the treatment of chronic anal fissure: Inicial experience [Retalhos de avanço no tratamento da fissura anal crônica - experiência inicial]

Abstract

The anal fissure is a laceration of the anal canal related to trauma, hypertonic sphincter and ischemia. The majority heals spontaneously or with conservative treatment and only a few requires surgical treatment. The objective of this study is to verify the clinical results and manometric alterations of patients submitted to the surgical treatment of the anal fissure with advance of v-y skin flaps. Methods: Prospective study, accomplished in 2007,2008 and 2009, in witch nine patients with chronic anal fissure were submitted to v-y advance. The pressures of the anal canal at rest, contraction and at evacuation effort were evaluated in the pre and postoperative. Results: In the sample, all the patients had presented previous hypertonic sphincter. six (66.6%) had gotten total resolution of the symptoms and the injuries. One (16.6%) suffered partial dehiscence of the flap, without clinical symptoms; and another two (22,2%), infection with loss of the same and persistence of the fissure. The manometric analysis of the pressures at rest, contraction and evacuation did not show significant statistical alteration (p> 0,05), what proves that the surgery did not manipulated the sphincters. Conclusion: The anal flap had revealed an effective treatment of the anal fissure with total healing of the injury, without alterations in the pressures of the sphincters.