ANORECTAL PRESSURE MEASUREMENTS AND THE DETERMINATION OF SURGICAL TREATMENT IN HEMORRHOIDS AND ANAL FISSURES
ABDULLAH İĞCİ, TUNÇ YALTI, VAHİT ÖZMEN, YAVUZ BOZFAKİOĞLU, MUSTAFA KEÇER
İstanbul Üniversitesi, İstanbul Tıp Fakültesi Genel Cerrahi A.B.D. C Servisi İSTANBUL
Abstract
Anorectal pressure measurements were performed to 23 chronic anal fissures, to 27 hemorrhoids and to 20 other patients with various diagnosis hospitalised in the General Surgical Division Unit C of İstanbul Medical Faculty during 1987-1989. Patients with anal fissures and hemorrhoids were observed to have statistically higher anorectal pressure than controls (0.01).
Chronic anal fissures and symptomatic (with bleeding and pain) hemorrhoids were treated with lateral internal sphinchterectomy (LIS) while the remaining 8 hemorrhoid patients with prolabing packs underwent exision.
The pressure measurements performed on the fifth postoperative day revealed that the patients underwent LIS had returned to normal levels. After the follow-ups done at the sixth and twelfth month it was observed that symptoms and signs had completely disappeared in all of the anal fissures cases and in 93.3% of hemorrhoid patients.
According to these results it can be concluded that hemorrhoid patients with bleeding and pain symptoms have high anorectal pressures. For this reason LIS is an effective treatment modality for hemorrhoid patients in the same way as anal fissure patients.