Perioperative management - Anal fissurectomy - general and visceral surgery
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Indication
- Chronic fissure in ano with secondary changes
- Fissure in ano without secondary changes, but refractory to treatment
Contraindication
- Fistula in ano
- Acute fissure
- Cancer
- Relative contraindication in systemic disease (AIDS, IBD)
Preoperative diagnostic work-up
Proctological examination: Inspection, palpation, proctoscopy, rectoscopy
Special preparation
- None
- Enema, if necessary
Informed consent
General:
- Bleeding
- Thrombosis
- Embolism etc.
Specific:
- Secondary impairment of fine continence (e.g. stool spotting)
- Sensory deficit with incontinence symptoms or stenosis
- Stenosis through scarring
- Secondary wound healing
- Abscess
Anesthesia
Positioning
Operating room setup
Special instruments and fixation systems
Postoperative management
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