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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
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.
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.
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.
Département de Chirurgie Digestive et Oncologique, Service de Chirurgie Digestive et Oncologique, Pôle d'Oncologie des Spécialités Médicales et Chirurgicales, Hôpital Timone, 267, Rue Saint Pierre, 13385, Marseille Cedex 05, France, mehdi.ouaissi@m
This article was published in the following journal.
Name: World journal of surgery
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Endonucleases that remove 5' DNA sequences from a DNA structure called a DNA flap. The DNA flap structure occurs in double-stranded DNA containing a single-stranded break where the 5' portion of the downstream strand is too long and overlaps the 3' end of the upstream strand. Flap endonucleases cleave the downstream strand of the overlap flap structure precisely after the first base-paired nucleotide, creating a ligatable nick.
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A surgical technique to correct REFRACTIVE ERRORS of the EYE, such as MYOPIA and ASTIGMATISM. In this method, a flap of CORNEAL EPITHELIUM is created by exposure of the area to dilute alcohol. The flap is lifted and then replaced after laser ablation of the subepithelial CORNEA.
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