General Information
DEFINITION--Removal of an anal fissure, a crack or tear in the membrane that
lines the anus, and incision of the muscular anal sphincter.
BODY PARTS INVOLVED--Anus and lining membrane; anal muscles (sphincter).
REASONS FOR SURGERY--Relief of pain.
SURGICAL RISK INCREASES WITH
- Obesity; smoking.
- Recent or chronic illness.
- Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep
inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
- Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens;
marijuana; sedatives; hypnotics; or cocaine.
What To Expect
WHO OPERATES--General surgeon or proctologist.
WHERE PERFORMED--Hospital or outpatient surgical facility.
DIAGNOSTIC TESTS--Before surgery: Blood and urine studies; anoscopy;
sigmoidoscopy (See Glossary for all).
ANESTHESIA
- Local anesthesia by injection.
- Spinal anesthesia by injection.
- General anesthesia by injection and inhalation with an airway tube placed in the
windpipe.
DESCRIPTION OF OPERATION
- The sphincter is expanded with special instruments.
- The fissure is cut free from surrounding tissue and removed. Sometimes, the sphincter
muscles are cut to prevent recurrence.
- Bleeding vessels are tied or closed with electrocauterization.
- A drain or packing is inserted into the surgical area.
- The surgical area is left open to hasten healing. Bandages are applied.
POSSIBLE COMPLICATIONS
- Excessive bleeding or pain.
- Surgical-wound infection.
- Inability to control bowel movements until healing is complete.
- Incontinence, if all or part of sphincter is removed.
AVERAGE HOSPITAL STAY--0 to 1 day.
PROBABLE OUTCOME--Expect complete healing without complications. Allow about 3
weeks for recovery from surgery.
Postoperative Care
† Use an electric heating pad, a heat lamp or a warm compress to relieve surgical--
wound pain.
- Use soft moistened tissue to clean the anal area after bowel movements.
† You may use non--prescription drugs, such as acetaminophen, for minor pain.
† To help recovery and aid your well--
being, resume daily activities, including work, as soon as possible.
- Avoid vigorous exercise for 4 weeks after surgery. > Resume driving 1 week after
returning home.
DIET--Eat a well--balanced diet to promote healing. Increase fiber and fluid
intake to prevent constipation.
Call Your Doctor If
† Pain, swelling, redness, drainage or bleeding increases in the surgical area.
- You experience nausea, vomiting or constipation.
- You develop signs of infection: headache, muscle aches, dizziness or a general ill
feeling and fever.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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