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Article
Microleakage evaluation of two types of pit and fissure sealants using two different methods, (in vitro study)

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Abstract

Background: Clinical preventive procedures must be done after careful assessment;one of the major risk factor is the occlusal morphology of the posterior teeth. Thesecaries free fissures must be sealed. This in vitro study evaluated the microleakage oftwo types of sealant materials (unfilled resin and flowable composite) on enamelsurfaces prepared using two methods (acid etching with enameloplasty and acidetching alone).Material and methods: Thirty two extracted human third molar were selected andrandomly assigned in to 4 groups of eight teeth each; group A, the occlusal surfaces ofteeth were acid etched ,then sealed with concise white sealant; group B, they wereacid etched then sealed with wave mv flowable composite ;group C, they wereprepared with bur ,acid etched ,then sealed with concise white sealant ;group D, theywere prepared by bur, acid etched, then sealed with wave mv flowable composite. Thesealed surfaces were stored for seven days in distilled water, then specimens werethermocycled 500 cycles, immersed 24 hours in a 2% buffered methylene blue dye,then sectioned and analyzed for leakage under a stereo microscope. Chi-square testwas performed to test the differences of leakage among the four groups.Results: The results showed that there was no significant difference (p>0.05) inmicroleakage for the same material with and without bur preparation. Concise whitesealant produced significantly (p<0.05) less microlaekage than wave flowablecomposite.Conclusion: under the conditions of the present study, bur preparation(enameloplasty) followed by acid etching produces no less microlaekage than did acidetching alone. Concise white sealant (unfilled resin) demonstrated less amount ofmicrolaekage when compared to wave mv flowable composite.


Article
Evaluation of Pit and Fissure Sealant With and Without Topical Fluoride Application
تقييم ختم التجويف والشق مع وبدون استعمال الفلورايد الموضعي

Author: Huda E. Ali Al-Rubaye هدى الياس علي الربيعي
Journal: Al-Rafidain University College For Sciences مجلة كلية الرافدين الجامعة للعلوم ISSN: 16816870 Year: 2014 Issue: 33 Pages: 235-254
Publisher: Rafidain University College كلية الرافدين الجامعة

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Abstract

The majority of the detected increment in dental caries is confined to pit and fissure surfaces of teeth. Application of pit and fissure sealants and topical fluorides are widely used procedures in the prevention of decay.The purpose of this study was to evaluate the effectiveness of pit and fissure sealant with and without topical fluoride application in the prevention of dental caries on the occlusal surfaces of teeth in children.93healthy cooperative children of both sexes with an average age (7-9 years) were included in this study, accordingly, 120 permanent first molars that were caries-free and fully erupted divided into two groups: sealant group (sealant applied on 60 permanent first molars) and sealant withfluoride group (sealant plus fluoride gel applied topically every three months intervals for 24 months on 60 permanent first molars). All children were recalled for assessment of fissure sealant and the presence or absent of dental caries at intervals of 6, 12, 18 and 24 months.The statistical analysis shows that there was no significant differences in the presence and absent of dental caries on the occlusal surfaces of the teeth between sealant group and sealant with fluoride group at baseline time and at 6, 12, 18 and 24 months intervals of recall assessment.There was some evidence about the superiority of pit and fissure sealant over topical fluoride application in the prevention of occlusal decay. However, it remained unclear to what extent there is differences between the effectiveness of pit and fissure sealant with and without topical fluoride application. No recommendation for the clinical practice could be given and the benefit of pit and fissure sealant with and without topical fluoride application should be considered locally and individually.

غالبية الزيادة في الكشف عن تسوس الأسنان يقتصر على ختم تجويف وشق الأسنان. وتستخدم على نطاق واسع ختم التجويف والشقوق والفلورايد الموضعي للوقاية من التسوس. كان الغرض من هذه الدراسة تقييم فعالية ختم التجويف والشقوق مع وبدون استعمال الفلورايد الموضعي في الوقاية من التسوس على سطوح الأسنان عند الأطفال.93 طفلا متعاونا وصحيا من كلا الجنسين يبلغ متوسط أعمارهم (6-9 سنوات) ادرجو في هذه الدراسة, وفقا لذلك,(120) من الأضراس الدائمة الأولى خالية من التسوس والتي بزغت بالكامل في الفم قسمت إلى مجموعتين: مجموعة الختم (60 ضرس دائمي أول) ومجموعة الختم مع الفلورايد (استعمال هلام الفلورايد موضعيا كل ثلاثة أشهر لمدة 24 شهر على 60 ضرس دائمي أول). جميع الأطفال استدعوا لتقييم ختم الشق وكذلك وجود أو غياب تسوس الأسنان على فترات 6, 12, 18 و24 شهرا.أظهر التحليل الإحصائي عدم وجود فروق ذات دلالة إحصائية في وجود وغياب التسوس على سطوح الأسنان بين المجموعتين في وقت خط الأساس وبعد 6, 12, 18 و 24 شهرا في فترات الاستدعاء للتقييم. كان هناك بعض الأدلة حول تفوق ختم التجويف و الشق على استعمال الفلورايد الموضعي في الوقاية من تسوس سطوح الأسنان. مع ذلك, فانه لا يزال غير واضح إلى أي مدى هناك اختلافات بين فعالية ختم التجويف والشق مع وبدون استعمال الفلورايد الموضعي.ا يمكن إعطاء أي توصية للممارسة السريرية وينبغي النظر في الاستفادة من ختم التجويف والشق مع وبدون استعمال الفلورايد الموضعي محليا وبشكل فردي. كلمات مفتاحية: ختم التجويف والشق, الوقاية من التسوس, الفلورايد الموضعي, تجربة سريرية.


Article
EFFICACY OF BOTULINUM TOXIN TYPE A IN THE TREATMENT OF CHRONIC ANAL FISSURE

Author: Ibrahim Falih Noori
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 1 Pages: 69-75
Publisher: Basrah University جامعة البصرة

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Abstract

Lateral partial internal sphicterotomy has been the goal standard for the treatment of chronic anal fissure. The main drawback of this approach remains its effect on the anal continence. Intrasphincteric of botulinum toxin seems to be a reliable and safe option resulting in temporary paralysis of the internal sphincter spasm and so promoting the chronic fissure to heal. The aim of this prospective control randomized study was to compare the effectiveness and the outcome of botulinum toxin injection with the lateral internal sphicterotomy in the treatment of the chronic anal fissure. Ninety male patients who have been presented with chronic uncomplicated anal fissure, were randomized to either lateral internal sphincterotomy or intrasphincteric injection of botulnium toxin. Postoperative complications and pain, healing rate of the fissure, anal incontinence and recurrence of the fissure after treatment during six months follow up period were studied and assessed. The healing rate was 95.5% in the surgical group with recurrence noted in only one patient and one patient had a partial permanent incontinence while in the botulnium toxin group the healing rate was 84.4%. Two patients had transient incontinence which improved spontaneously over six months period. Five patients had recurrence within the same follow period. Lateral internal sphicterotomy and botulinum toxin injection both seems to be effective treatment of the chronic anal fissure. Although surgical approach is still the most common and gold standard treatment for the chronic anal fissure, It shows a higher incidence of incontinence and greater morbidity and pain than botulinum toxin injection. We conclude that the use of botulinum toxin to treat chronic anal fissure is safe, simple and effective approach especially in patients older than 50 years or those with risk of anal incontinence despite the higher rate of recurrence which can be minimized by the second session of botulinum toxin injection.


Article
Assessment of hemorrhoids and anal fissure occurrences in women during pregnancy in Pirmam City/Iraq
تقييم حدوث البواسير و الناسور الشرجى عند النساء أثناء الحمل في مدينة بيرمام/العراق

Authors: Pola Farhad Hassan --- Hamdia Mirkhan Ahmed Lecturer
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 2 Pages: 58-64
Publisher: University of Kufa جامعة الكوفة

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Abstract

Aim: The aim of this study was assessment of obstetrical characteristics of women with hemorrhoids and anal fissure. Methods: A cross-sectional study was conducted between 1st September 2013 and 30th July 2014 in Pirmam city in Kurdistan Region of Iraq on 50 women who attend surgical private clinic and complained with signs and symptoms of hemorrhoids and anal fissures and diagnosed by observation and physical examination of the anus. A questionnaire was constructed for the purpose of the study. Chi-square test or Fisher exact test were used for analyzing of the data. Results: Mean (M±SD) age of women were 30.36 (± 7.4). The rate of hemorrhoids, fissures or both were as following respectively: 14%, 48% and 38%. Sixty two percent of the study sample were multipara. The majority (84%) of the sample had vaginal delivery. There was statistically significant association between prolonged labor with aggravation of hemorrhoids and fissures by pregnancy/delivery but there was no statistically significant association between onset of hemorrhoids or fissures and their aggravation by pregnancy/delivery with parity and mode of delivery.Conclusions: Hemorrhoids and anal fissures were most common in multipara and grand multipara women and who delivered vaginally. These conditions may aggravated by pregnancy and delivery.Recommendation: Advising and educating women for appropriate diet and bowel motion during pregnancy and improving care during labor may decrease the hemorrhoids and anal fissures. Further studies with large sample size and case- control study will help to understand the effect of childbearing experience on anal disorders

الهدف: تهدف الدراسة الى اجراء عملية تقييم مواصفات التوليد للنساء المصابات بالبواسير و الناسور الشرجى.المنهجية: أجريت دراسة مقطعيه للفترة من1/9/2013 - 30/7/2014 في مدينة بيرمام في اقليم كوردستان/العراق. و قد شملت الدراسة 50 امرأه من المراجعات العيادة الجراحية الخاصة و اللواتى يعانين و اللذين كان يعانون من اعراض و علامات الاصابه بالبواسير و الناسور الشرجى. و قد تم تشخيصهم من خلال الفحص السريري مسبقا. وتم اعداد استماره استبيانية لهذا الغرض. و تم استخدام مربع كاي لتحليل النتائج .النتائج: اظهرت النتائج ان معدل المتوسط و(الانحراف المعيارى) لأعمار النساء هو 30.36 (±7.4). و كانت نسبة الأصابه بالبواسير(14%) و الناسور (48%) او كلاهما (38%). و أظهرت النتائج بأن 62% من النساء كانت متعددات الولادات. وكان نسبة (84%) منهم لديهم ولادة طبيعية. و كان هنالك دلالة احصائية بين طول فترة الولادة و شدة الصابة الأصابة بالبواسير و الناسور. واظهرت النتائج بأنه لم تكن هنالك علاقة ذات دلالة احصائية بين بداية الأصابة بالبواسير و الناسور و شدة مع عدد الولادات او طريقة الولادة.الاستنتاج: ان البواسير و الناسور الشرجى كانت أكثر شيوعاَ لدى النساء المتعددات الولادات والذين لديهم اكثر من خمسة ولادات و كذلك بين نساء ذات الولادة الطبيعية. التوصيات: اعطا النصيحه و التثقيف للامهات حول الغذاء المناسب و حركة الامعاء خلال حمل و تحسين الرعايه خلال الولادة والتى قد تقلل البواسير والناسور الشرجى. الحاجه الى دراسات اخرى و بعينة اكبر و اجراء دراسة من نوع الشاهد والحالة التي قد تساعد لمعرفة تأثير الحمل على إصابات الشرج.


Article
Anal Fissure Treatment by Medication and Surgery

Author: Ali Abdulhaleem Kadhim
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 323 -329
Publisher: Babylon University جامعة بابل

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Abstract

Anal fissure is a most common cause of anal pain [1].This prospective study includes 236 patients complaining of anal fissure treated from a period of September 2013 to December 2015 to assess options of management of anal fissure. Male patients were 121 (51%) and female were 115 (49%). All patients were clinically assessed in an outpatient clinic and conservative treatment started to all patients that shown to be effective in 141 patient (60%). Surgical treatment applied to 95 patients (40%)whom not responded to conservative treatment, or, patients with recurrent fissure. Lateral sphenectrotomy was the surgical procedure applied in open or close method (62 and 33 patients respectively), under local or general anesthesia (54 and 41 respectively). Local anesthesia was associated with a significant low duration of admission from 1 to 24 hours (mean of 3 hours) while general anesthesia with a significant higher duration of 12 to 36 hours (mean of 19 hours). The healing rate following surgery in a local or general anesthetic approach was 95%. No difference in a healing rate between open or closed technique of sphenectrotomy. Flatus incontinence was reported in 3 patients. Initial treatment of anal fissure should be conservative, lateral sphenectrotomy is a safe procedure with a high cure rate, low incidence of complications and could be performed under local or general anesthesia.


Article
Chemical sphincterotomy is good alternative option to surgery In Management of chronic fissure in ana

Author: Ali Mahmood Ghazi علي محمد غازي
Journal: AL-yarmouk Journall مجلة كلية اليرموك الجامعة ISSN: 20752954 Year: 2017 Volume: 9 Issue: 9 Pages: 95-100
Publisher: College Yarmouk University كلية اليرموك الجامعة

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Anal fissure is a common disorder which may cause symptoms at any age. Internal anal sphincterotomy is the gold standard surgical treatment which lowers the resting anal pressure and effectively heals the majority of fissures. However the post operative period may be marked by surgical risks, complications and late incidence of incontinence that is some times permanent. These complications have led to a search for alternative therapies for the treatment of chronic anal fissure. Chemical sphincterotomy has been tried using a variety of novel agents including topical glyceryl trinitrate (GTN), calcium channel blockers such as nifedipine or diltiazem and botulinum toxin. Some of these agents were found to be effective in healing chronic anal fissure with negligible side effects and are now considered as first line treatment for chronic anal fissure

استخدام العلاج الكيماوي في علاج الفطر الشرجي المزمن كبديل للعملية الجراحية وتبين لي ذلك من خلال دراسة اجريتها على مرضى في مستشفى الثورة التعليمي البيضاء ليبيا وفي مستشفى الكرامة التعليمي بغداد وعيادتي على مرضى يعانون من مرض الفطر الشرجي المزمن وعددهم 105 مرضى. النتائج سبعون مريض من مجموع مائه وخمسة مرضى استخدموا العلاج لمدة شهر ونصف تماثلوا للشفاء التام وكانت الدراسة من كانون الأول 2009 الى 2016. استنتاجات نستنتج من الدراسة بان العلاج الكيماوي للفطر الشرجي المزمن فعال وامن وبدون مضاعفات مقارنه بالعملية الجراحية التي ممكن يحدث فيها مضاعفات كعدم السيطرة على الهواء الذي يخرج من الشرج او البراز.


Article
Establishing the Superiority of Topical Diltiazem Over Compound Cream in the Treatment of Chronic Anal Fissure: A Prospective Analytical Study

Author: Ahmed Nasser Hussein, Maytham Hatam Shahid, Abd Alkhaliq S Abdullah
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 4 Pages: 434-437
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Anal fissure is an elliptical ulcer in the anal canal extending from the dentate line to the anal verge; chronic anal fissure is a common problem across the world treated largely by surgical methods. The treatment for chronic anal fissure (CAF) has undergone a transformation in recent years from surgical to medical as the common goal is reducing the internal anal sphincter spasm.OBJECTIVE:To assess the efficacy of topical treatment with 2% diltiazem gel (DTZ) in patient with chronic anal fissure versus combination cream.MATERIAL AND METHODS:Consecutive 400 adult male patients with symptomatic chronic anal fissure attending the surgery clinic were enrolled in the study form February 2014- July 2016, 200 patients were treated with topical application of 2% DTZ cream, other 200 patients were treated with combination cream. Patients were followed up for 6 month at regular intervals for symptomatic relief and healing of fissure.RESULT &CONCLUSION:In our study diltiazem 2% gel was more effective than combination cream in the treatment of chronic anal fissure..


Article
Anal Fissure: Is it becoming a medical disorder?

Author: Ali Al-shaham, CABS*. Kadhim Jawad, CABS**, Serene A.A, MS***
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 2 Pages: 1-4
Publisher: Baghdad University جامعة بغداد

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An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.


Article
Topical Combination of Nifedipine with Lidocaine is a Promising Medical Treatment for Anal Fissure
استخدام النفدبين و الليدوكائين كعلاج واعد للفطر الشرجي

Authors: Nahedh R Alammar ناهظ العمار --- Adel Musa Al-Rekabi عادل موسى الركابي --- Rasha Kadim Albayati رشا كاظم البياتي
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2018 Volume: 15 Issue: 2 Pages: 98-103
Publisher: Diyala University جامعة ديالى

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Background: A fissure consist of crack or tear in the vertical axis of the anal canal between the anal verge and the dentate line. Anal fissure is the most common cause of sever anal pain and bleeding. Anal fissure is an elongated ulcer in the anoderm below the dentate line, and is commonly located posteriorly due to more adherence of the anoderm to the underlying tissue in the posterior midline, so the blood supply is significantly low as shown by the Doppler flowmetry study. Anal fissure is treated by two ways either medical or surgical treatment or both.Objective:To evaluate the healing response of the anal fissure to topical application of nifedipine with lidocaine. Patients and Methods: A randomized prospective study of one hundred patients who presented with anal fissure to outpatient surgical clinic in Al-Diwaniyah teaching hospital. The patients were divided into two groups. The first group involve 40 patients (15 males and 25 females) with acute anal fissure; the second group 60 patients (25 males and 35 females) with chronic anal fissure. Both groups were treated with the topical application of nifedipine and lidocaine 3 times daily for 6 weeks, and more prolonged therapy (up to 8 weeks) was applied for resistant cases. Results: Both groups registered good response to topical therapy; the healing response was 85%. The healing response of those with acute anal fissure was better and faster than patients with chronic anal fissure.Conclusion: Anal fissure can be simply and effectively treated medically without the risk of incontinence associated with lateral internal sphincterotomy.

خلفية الدراسة: الفطر الشرجي هو من اكثر الأسباب المسببة للأم والنزف الشرجي وعادة يكون مكانه في الجزء الخلفي لفتحة الشرج حيث يكون تدفق الدم اقل من الأماكن الأخرى للشرج. السبب الرئيسي للفطر الشرجي هو الأمساك المزمن.اهداف الدراسة: هدفت هذه الدراسة لتقييم الاستجابة للعلاج الموضعي للفطر الشرجي بأستعمال مرهم النيفدبين مع مرهم الليدوكائين.المرضى والطرائق: دراسة مستقبلية تم فيها اخذ 40 مريض يعانون من فطر شرجي حاد و 60 مريض يعانون من فطر شرجي مزمن (المجموع مائة مريض) تم استقبالهم في العيادة الاستشارية الخارجية لمستشفى الديوانية التعليمي ولمدة سنة ابتداءاً من شهر كانون الثاني 2017 الى شهر كانون الثاني 2018 .كلا المجموعتين عولجوا باستعمال مرهم نفدبين مع مرهم ليدوكائين ثلاثة مرات يوميا لمدة 6 اسابيع واسبوعين اضافيين للحالات غير المستجيبة للعلاج.النتائج: كانت الاستجابة للعلاج 85% بعد ثمانية اسابيع من العلاج وكانت الاستجابة في حالة الفطر الشرجي الحاد اسرع واحسن.الاستنتاجات : اظهرت النتائج استجابة جيدة للعلاج الموضعي يأستخدام مرهم النيفيديبين ومرهم الليديوكائين وهذا بالتالي يجنب تحول الفطر الحاد الى فطر مزمن وهذا الأخير يكون أضعف أستجابة للعلاج الموضعي.


Article
Cutting Whole Length or Partial Length of Internal Anal Sphincter in Management of Fissure in Ano

Author: Furat Shani Aoda,
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2018 Volume: 26 Issue: 1 Pages: 238-246
Publisher: Babylon University جامعة بابل

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Abstract

A chronic anal fissure is a common painful perianal condition. The main operative procedure to treat this painful condition is a lateral internal sphincteretomy (LIS).The aim of study is to compare the outcome and complications of closed LIS up to the dentate line (whole length of internal sphincter) or up to the fissure apex (partial length of internal sphincter) in the treatment of anal fissure. It is a prospective comparative study including 100 patients with chronic fissure in ano. All patients assigned to undergo closed LIS. Those patients were randomly divided into two groups: 50 patients underwent LIS to the level of dentate line (whole length) and other 50 patients underwent LIS to the level of fissure apex (partial length). Patients were followed up weekly in the 1st month, twice monthly in the second month then monthly for next 2 months and finally after 1 year. There was satisfactory relief of pain in all patients in both groups & complete healing of the fissure occurred. Regarding post operative incontinence no major degree of incontinence occur in both group but minor degree of incontinence persists In 7 patients after whole length LIS after one year. In conclusion, both whole length & partial length LIS associated with improvement of pain, good chance of healing but whole length LIS associated with more chance of long term flatus incontinence. Hence, we recommend partial length LIS as treatment for chronic anal fissure.

الفطر الشرجي المزمن هو حالة شائعه مؤلمة في المنطقه حول الشرج. والاجراء الجراحي الرئيسي لعلاج هذه الحالة المؤلمة هو استئصال جانبي للمصرة الداخلية .الهدف من هذه الدراسة هو مقارنة النتيجة ومضاعفات قص المصرة الداخلية الجانبية بالطريقه المسدوده الى الخط المسنن (كل طول المصرة الداخلية) او الى قمة الفطر (جزء من طول المصرة الداخلية) كعلاج للفطر الشرجي. هذه الدراسة قائمة على المنهج المقارناجريت في مستشفى البصرة العام للفتره من الشر العاشر 2008 حتى الشهر العاشر 2013 حيث تضمنت 100 حالة مرضية تعاني من الفطرالشرجي المزمن. جميع المرضى وافقوا على استئصال المصرة الداخلية بالطريفه المسدوده ,ثم تم تقسيم المرضى بالطريقة العشوائية الى مجموعتين .50 مريضا خضع الى استئصال المصرة الداخلية الى الخط المسنن( طوله كله)و 50 مريضا خضعوا الى عملية الاستئصال الى مستوى قمة الفطر(جزء من الطولة). تم متابعة المرضى أسبوعيا خلال الشهر الأول. ومرتين في الشهر الثاني وبعد ذلك شهريا في الشهرين التاليين ومرة اخيرة بعد سنة كاملة. حيث كان هناك ارتياح جيد من الألم لدى كل المرضى وشفاء كامل للشق لدى المجموعتان. فيما يخص السلس بعد العملية لا وجود للسلس بدرجة كبيرة (عدم السيطره على الخروج)لدى المجموعتان لكن ظهر سلس من الدرجه البسيطه (عدم السيطره على خروج الهواء) لدى 7 حالات فقط للذين خضعوا للاستئصال الكامل للمصرة بعد سنة كاملة. نستنتج ان كلتا الاستئصالان الكامل و الجزئي للمصرة الداخلية أدى الى تحسن حالة المريض والتخلص من الألم لكن الاستئصال الكامل كان مصحوب لفترة طويلة للدرجه البسيطه من السلس. ولذلك ننصح بالاستئصال الجزئي للمصرة الداخلية الجانبية كعلاج للفطر الشرجي المزمن.

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