Perioperative management - Anal fissurectomy

  1. Indication

    • Chronic fissure in ano with secondary changes
    • Fissure in ano without secondary changes, but refractory to treatment
  2. Contraindication

    • Fistula in ano
    • Acute fissure
    • Cancer
    • Relative contraindication in systemic disease (AIDS, IBD)
  3. Preoperative diagnostic work-up

    Proctological examination: Inspection, palpation, proctoscopy, rectoscopy

  4. Special preparation

    • None
    • Enema, if necessary
  5. 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

Depending on the general condition of the patient:General anesthesia, Laryngeal mask airway anesthe

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