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Anal Surgery: Organ and Function Preservation

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Coloproctology

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Abstract

Anorectal disorders such as hemorrhoids, anal fissure, and anal fistulas are common in Western countries. Medical management may resolve symptoms in patients with hemorrhoids and anal fissures, but some patients will require surgery. Intervention is necessary most of the time in patients with anal fistulas. Mortality and significant morbidity are rare after such surgery, but functional disorders particularly incontinence may occur in a significant percentage of patients. Lateral internal sphincterotomy, the current standard procedure for anal fissures, carries a risk of minor incontinence of 15–45 %. Incontinence after hemorrhoidectomy is less common and may be minimized by careful surgical technique. The highest risk of incontinence occurs with fistula surgery. For those patients, preoperative risk factors, clinical symptoms, and the anatomy of the fistula should be carefully assessed. Treatment plans must balance the predicted success against the risk of incontinence.

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  1. Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA

    Ann Lowry

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  1. Catholic University, Roma, Italy

    Carlo Ratto

  2. Catholic University, Roma, Italy

    Angelo Parrello

  3. Catholic University, Roma, Italy

    Lorenza Dionisi

  4. Catholic University, Roma, Italy

    Francesco Litta

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Lowry, A. (2015). Anal Surgery: Organ and Function Preservation. In: Ratto, C., Parrello, A., Dionisi, L., Litta, F. (eds) Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-10154-5_12-1

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