ABSTRACT
Objective To compare the clinical efficacy of two surgical methods for the treatment of anal fissures in elderly patients.Methods A total of 138 elderly patients with anal fissures treated at our hospital from January to December 2016 were randomly divided into the conventional method group(69 cases) and the modified method group (69 cases).Patients in the conventional method group were treated with lateral sphincterotomy,while patients in the modified method group were treated with modified longitudinal sphincterotomy with transverse suture.Outcomes of treatment,VAS scores,incision wound infection rates,postoperative voiding dysfunction rates and recurrence rates were compared.Results There was no significant difference in overall effectiveness between the modified method group (98.6％)and the conventional method group(94.2％) (x2=1.8677,P=0.1717).The rates of incision wound infection,moderate postoperative urinary retention and recurrence in the conventional method group(8.7％,42.0％ and 10.1 ％,respectively)were significantly higher than those in the modified methods group(0.0 ％,15.9 ％ and 0.0％,respectively) (x2 =4.3561,11.4061 and 5.4177,respectively,P =0.0369,0.0007 and 0.0199,respectively).At 12 hours after operation,favorable VAS scores and incision healing times were observed in the modified method group,compared with the conventional method group,and the differences were statistically significant(each P＜0.05).Conclusions Modified longitudinal sphincterotomy with transverse suture produces about the same overall effectiveness as does lateral sphincterotomy in the treatment of elderly patients with anal fissures,but it is superior in reducing incision wound infection,moderate postoperative voiding dysfunction,recurrence and pain intensity,and in promoting incision healing.
ABSTRACT
Objective To compare the clinical effect of surgery with longitudinal incision and transverse suture in the treatment of anal fissure excision of anal fissure.Methods 60 patients with anal fissure who required surgery were selected,and they were randomly divided into two groups according to the digital table.30 patients in the control group received anal fissure resection,30 cases in the observation group received anal fissure longitudinal incision and transverse suture treatment.The clinical curative effect was compared between the two groups.Results The effective rate of the control group was 93.33％,which of the observation group was 96.67％,there was no significant difference between the two groups (P ＞ 0.05).The postoperative pain score of the control group was (3.89 ±1.30) points,which of the observation group was (1.33 ± 1.20) points,there was significant difference between the two groups(t =8.449,P＜ 0.05).The incidence rate of complication of the control group was 6.67％,which of the observation group was 23.33％,there was significant difference between the two groups (x2 =9.524,P ＜ 0.05).Conclusion The surgical treatment of anal fissure,surgery and excision of anal fissure anal fissure joints have advantages and disadvantages according to the treatment of transverse slitting,the specific patient should select the specific surgical methods.
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Objective To explore the clinical effects of modified longitudinally cut transverse suture operation for patients with chronic anal fissure. Methods 56 patients with chronic anal fissure were randomly divided into two groups ( each group with 28 patients) . The con-trol group received routine longitudinally cut transverse suture operation, and the observation group were given modified longitudinally cut transverse suture operation. The chages of anal canal diameter, postoperation pain, edema, healing time and infection of the two groups were compared. Results The postoperative anal canal diameter were significantly increased (P0. 05). The observation group were of significantly lighter postoperative pain and edema, significantly shorter wound healing time, lower wound infection rate than the control group (P<0. 05). The follow-up showed there were no serious complications and recurrence. Conclusion The treatment of modified longitudinally cut transverse suture does not increase the difficulty of operation, while it can faster the recovery with fewer complications. It is worthy of promotion.
ABSTRACT
Skull is usually available human bone for establishing personal identity. Presence of Inca bone in human skull is one such feature that may be identified on radiological examination and if earlier recorded help in establishing the identity of deceased. Complete division of membranous and cartilaginous part of occipital bone by a transverse suture extending between the two lambdoid sutures at the level of highest nuchal line above the external occipital protuberance, results in rare cranial variation presenting as Inca bone.During medicolegal examination of one male skull at Madhya Pradesh Medicolegal Institute Bhopal, presence of Inca bone was found. The interparietal bone is formed by a part of the squamous occipital bone bounded by two lambdoid sutures on two sides and additional longitudinal suture on both sides between lambdoid suture and external occipital protuberance forming diamond shaped Os Incae Centrale that can also be considered as intra-occipital bone. Such rare findings have significant anthropological and embryological basis. Specific anatomical feature if earlier documented in the clinico-radio-pathological reports of the deceased provides opportunity for establishing the identity.