title: Endoscopic anal dilatation for fissure-in-ano: a new outpatient treatment modality.
abstract: We describe a new therapeutic procedure for fissure-in-ano, endoscopic anal dilatation. Anal dilatation is performed with a two-valved anoscope under local anesthesia in an ambulatory setting. We report our results using this technique in 62 patients after a mean follow-up of 19 months (range: 12-24 months). Thirty days after the procedure, 55 patients (93%) were symptom-free, whereas 3 of them (4.8%) failed to improve. After nineteen months, one patient out of 47 in follow-up had a recurrence. No bleeding, discharge or defects of continence, either transient or permanent, were noted. The results of endoscopic anal dilatation are comparable with those of lateral sphincterotomy, can be achieved at a lower complication rate, with only minor and temporary complications, and performed by physicians with no specific surgical training.
authors.affiliation: Gastroenterology Department, Hospital de la Princesa, Universidad Autónoma de Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Miranda
authors.forename: P
authors.initials: P
authors.lastname: Robledo
authors.forename: M
authors.initials: M
authors.lastname: Alcalde
authors.forename: A
authors.initials: A
authors.lastname: Gómez-Cedenilla
authors.forename: J
authors.initials: J
authors.lastname: Maté Jiménez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D004106:Dilatation / Q000009:adverse effects; D004724:Endoscopy; D005260:Female; D005401:Fissure in Ano / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D013997:Time Factors