LONG-TERM OUTCOMES OF SURGICAL TREATMENT OF CHRONIC ANAL FISSURES

Abstract

Aim. To improve the results of surgical treatment of patients with chronic anal fissures in the remote period. Materials and methods. The current work analyzes the results of a clinical study of 112 patients with chronic anal fissures (CAF) in the remote period after the surgery that ranged from 6 months to 4 years. The examination methods included a visual examination, functional examination of the rectal obturator with sphincterometry and manometry, as well as the study of the final products of lipid peroxidation and the state of antioxidant protection of the blood plasma and biopsies of the rectal mucous layer. Results and discussion. Evaluation of the surgical treatment of chronic anal fissures was based on the long-term results of two groups of patients: the main group - 64 patients and the control group - 48 patients. Positive treatment results were managed to achieve in 58 (91%) out of 64 cases of patients with chronic anal fissures in the main group. Satisfactory treatment results were achieved in 4 (6.2%) patients, unsatisfactory results were observed in 2 (3.1%) patients with severe chronic anal fissures, after 6 months. Following results were observed in the control group: good results - 37 (77.0%) cases; satisfactory results - 6 (12.5%) cases; unsatisfactory results - 5 (10.5%) cases. Conclusion. The use of differentiated surgical approach, taking into account the severity of the chronic anal fissures, lipid peroxidation and antioxidant protection, significantly improved the long-term results of surgical treatment of chronic anal fissure in 91% of cases and significantly reduced the recurrence rate of the disease to 7.5% in comparison to patients of the control group.