Sphintersomy, also called lateral internal sphincterotomy, is a type of procedure that is used to cut an anal sphincter.The anal sphincter
is a group of muscles connected to a straight whale, at the end of the digestive tract through which the intestinal movements are passed.This surgery is performed when an anal crack (rupture on the skin of the anus) did not work better after testing other procedures. Cracks can bleed and be painful and, in some cases, can pick up time for treatment.
In most cases, cracks can be lingered at home, sometimes even without treatment. However, when healing takes too much time, he can consider the operation.Sphincterotomy is considered a gold standard for the treatment of chronic anal cracks, and the speed of success is generally informed as more than 95 percent, depending on the study.
What anal cracks?
The injury on the tissue cover of the anal channel can lead to a tear or breakage, which is called a crack.Anal cracks can cause symptoms of pain, bleeding, itching and pain during intestinal movements . Suffects, which are superficial and can be cured quite fast, are considered sharp without any treatment.Those who are deeper and still do not cure after treatment or in a few weeks they can be considered chronic.
Cracks are the most often caused by a rigid stool (which can be, but not always connected with
With certain medical conditions, such as hypothyroidism, obesity and chronic constipation, are also associated with an increased risk of anal crack.
Initially, the anal cracks are usually processed more conservative and remedies for the home. To make a chair smoother and easier to pass, eat more fibers and you can recommend the use of the soft chair.
If the stool can be transmitted without tension, it can help the crack to cure, and also reduce pain during intestinal movement.
Drinking more water can also help cut at the same time too complicated, and the bathrooms
sitz (sit on a small amount of warm water) can help the anal area feel better And also promote healing.In some cases, the local anesthetic ointment can be prescribed to reduce pain when the intestine moves.
Another treatment that can be used is the Botox injection, which are commonly used when other conservative measures have not been Worked.Botox blocks nerves that cause an anal sphincter husband who helps help a tear in the fabric for healing.
Figure> SHANNON FAGAN / GETTY images
Purpose of AspinkTherotomy
Show Botox procedures and / or injections do not work in theHealing the chronic anal crack, can be seen by the sphere. The anal sphincter has two muscles: internal and external muscle.The outer muscle is under voluntary control (it can be consciously compressed and not swing), and the internal muscle is controlled by the nervous system (can not be consciously monitored).
The muscles work together to keep the chair in the rectum (continued) and vice versa to allow the intestinal movement to leave the body.
Risks and contraindications
In most cases, sphincterotomy is successful, and patients are satisfied.However, as with any type of operation, there are certain risks, and there is a potential for complications.Some of the complications that can occur with sphincteromiotomy include:
Temporary implementation of incontinence: In some patients> incontinence incontinence in the period immediatelyAfter the operation. This can include a leak of a chair or difficulty in gas management. However, in most cases, this happens only in the first week or two after the operation.Rarely experience fecal incontinence after the healing period.
Hemorrhage. Hemorrhage or bleeding can occur after the surgical procedure, but this is a rare complication.In the event that there is an unexpected bleeding, some seams (stitches) can be used to stop bleeding.
perianal abscess. It is rare, but in some cases a closed technique is used, an abscess (GNI collection) can be developed with anal fistula.If this happens, the abscess may be necessary to be drained, and the other procedure can be done to eliminate the fistula, called the afeitulation.
Before the procedure
SPHINTERSMY is a kind of minor surgery, so the surgeon will give instructions on what to do to prepare.For a common anesthetic, it may be necessary to stop the food or drink at midnight during the night before the procedure.For local anesthetic instructions it can be the same or in some cases, food and drink can be resolved to a certain extent before the operation.
blood incitement or other medications that affect the thinning of blood, it is possible to stop within a few days before the operation.
It is important to tell the doctors in the office of all medicines and additives, which are currently accepted.
Patients will not be able to go home of this procedure, so you need a friend or family member to drive.
During arrival, a medical history will be adopted, which will include questions about any current medications or additives, any allergies and any past reaction to anesthesia or other medications.The forms of release must be signed before preparation for the procedure. IV will be placed for liquids and any drug (such as anesthesia need ). When it was time to start the procedure, the patient is wheel in the operating room.
During the procedure
The internal anal sphincter is always under a certain tension number. When this voltage becomes too big, you can take the muscle to try the spasm.Spasms can contribute to the development of the crack
or avoid healing. Aspinctrictial time is performed in the anal anal muscular sphincter, which reduces part of this voltage.Blood flow to the area also increases after the procedure, which helps crack to be treated.
The lateral internal sphincterotomy can be used asiplex or closed. The type of procedure will depend on a series of factors.In open surgery, anoscope is inserted into an anal sphincter to see the muscles and crack, and the incision is made.In a closed procedure, a small incision is made between the internal and external anal muscle sphincter, the scalpel is inserted inside, and the incision is made in the internal muscle.The closed technique may be preferable to surgeons that are specially trained to perform the operation in this way.
In most cases, Aspinkterotomy is carried out as an outpatient procedure.This can be done under local or common anesthesia. In some cases, the incision can be opened for treatment; In others, you can close. Mallar people can go home on the same day as the procedure.
After the procedure
After surgery, the bandage can be placed inside the anus.When the operation is completed, patients are controlled for several hours to make sure everything went well.After this period ended in restoration, patients will be downloaded at home or if you need to stay at the hospital, they will be delivered to the hospital room.
Most people will need at least one day to restore from general anesthesia and discover,What they need to stay at home from work and regular activity for approximately one week (or in some cases, about two weeks).The podiums can be sent home with a recipe to facilitate analgesics or other drugs and instructions on how to take them. In some cases, patients report that pain, tests after the procedure, less than that, which was caused by an anal crack.
Other home care instructions may include how to use the Sitz bath several times a day, as there is a diet with high fiber to help the chairs to be smoother and easier to pass,And drink plenty of water or other liquids that reject some cases The feces softeners
can also be prescribed.
In the first days, great pain may occur during the intestinal movement, so it will be important to keep the chair gently and avoid tension.
can be a bleeding for a week or more after the operation, but it must be seen mainly on paper after cleaning.
The recovery is usually insignificant, but any excessive pain or the Bleeding must be informed of a health care provider immediately.Most people feel better and less pain in a few days; However, you can take about 6 weeks to trim to try completely.
having incontinence incontinence, which is saved after the first days, is not common,
, but if Continue must be discussed with the health care provider.If the crack is returned (rare occurrence), you may need additional treatment.
Word of the information of the medications received
Cracks are common, and generally cure on your own.When they are not, the sphincterotomy, a good alternative, which generally leads to a complete recovery. People’s mining believes that the pain of surgery is less than pain in a crack, and can return to work or at school quite fast.
Foster for the implementation of instructions on a diet, the level of activity and the consumption of liquids, as well as any other direction of the surgeon, gives him to help the healing process.Concern about incontinence incontinence, pain or any other side effects can be created with a surgeon before and after the procedure to help reduce concern about sphere surgery.