Comparison of Fissurectomy to Fissurectomy With Anoplasty (ANOFIS)

Fondation Hôpital Saint-Joseph

Status: Completed

Conditions: Fissure Rectal

Study type: Observational

Funder types: Other

Identifiers

NCT04911023

ANOFIS

Details and patient eligibility

About

Surgery is sometimes necessary to relieve patients with chronic anal fissure. It consists of resecting the edges of the fissure to make a wound larger than the initial fissure, in order to obtain healing. Thus, the edges of the wound do not stick together and the healing is done from the bottom of the wound. This procedure is widely performed in France with results that seem satisfactory. In addition to resection of the fissure, a partial closure of the wound can be associated with a small flap of rectal mucosa which is sutured with a few absorbable stitches: this is anoplasty.

Full description

There is some debate as to whether to perform a fissurectomy alone or to complement it with an anoplasty to accelerate healing. The choice of technique performed depends on the training and habits of the operators but the results of fissurectomy alone and fissurectomy with anoplasty have never been compared. In the medical-surgical proctology department of the Groupe Hospitalier Paris Saint-Joseph (GHPSJ), both procedures are performed. The investigators therefore decided to compare the after-effects of fissurectomies alone with those of fissurectomies with anoplasty that were performed in the department in 2019. The choice between the 2 procedures is left exclusively to the discretion of the operator. The criteria for choice between the two patient populations are not different.

Enrollment: 226 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Major patient
• Patient managed in the proctology department of Groupe hospitalier Paris Saint-Joseph for single posterior idiopathic fissures (anoplasty possible only in the context of non-infected posterior fissure) between January 1 and December 31, 2019 by fissurectomy alone or fissurectomy with anoplasty

Exclusion criteria

• anterior or bipolar fissure
• infected fissure
• history of proctological surgery
• Crohn's disease
• HIV infection
• tubercular lesion validated by anatomopathology
• history of pelvic-perineal radiotherapy
• Tumor cells on histology
• fissurectomy +/- anoplasty associated with another proctological surgical procedure
• patient under guardianship or curatorship
• patient deprived of liberty
• patient under court protection
• Patient opposing the use of his data for this research

Trial design

226 participants in 2 patient groups

Patients operated by fissurectomy

Patients operated by fissurectomy with anoplasty