Colgajo anal cutáneo por deslizamiento: su utilización en patología ano orificial benigna / Anal cutaneous hanging tatter for slide: his utilization in pathology anus orificial benign

RESUMEN

Desde Julio del año 2004 a Septiembre del año 2008, se trataron 34 pacientes que presentaban patología ano-orificial beningna, mediante la realización del colgajo anal cutáneo por deslizamiento. La edad promedio fue de 59 años y el sexo predominante el masculino. Las patologías que presentaban fueron, enfermedad hemorroidal el 64%; estenosis anal 18% y fisura anal 18% del total de enfermos operados el 22% tenían como antecedente cirugía previa y de ellos el 50% fue por hemorroidectomía. La constipación crónica se asocia en un 98% a fisura anal; 65% a enfermedad hemorroidal y un 47% a estenosis del ano. El dolor anal presente en el 100% de los enfermos con estenosis anal y en un 92% en fisura anal. La proctorragia se presentó en el 85% de los pacientes con enfermedad hemorroidal; 73% en isura anal en un 40% en la estenosis anal.

ABSTRACT

Since July 2004 until September 2008, 34 patients with benign anal pathologywere treated by means of sliding skin anal grafts. The average was 59 years old and there were mostly male.The pathology that they presented was 64% hemorrhoids, 18% anal stenosisand 18% anal fissure; 22% of the patients had a previous surgery and 50% of them have had hemorroidectomy. Chronic head colding is associated with anal fissure in 98%, hemorrhoids in 65% and anal stenosis in 47% of the patients. Anal pain was present in 100% of the patients with anal stenosis and in 92% of the patients with anal fissure. Anal bleeding had been present in 85% of patients with hemorrhoids, 73% in anal fissure and 40% in anal stenosis. Before surgery 6 patients have had different incontinence degree, 3 referred to soild their underwear, 2 of them referred gases incontinence and 1 liquid soiling. Patients under sliding skin anal grafts surgery had a significant improvement; 28 days after surgery all of them had normal continence. Before surgery 7 patients had diminution of the anal diameter verified by the interrogatory and rectal tact. After 21 days from surgery, such diameter was considered as normal. Colonical cleanness is been made with monosodic/ bisodic phosphate with excellent results in all the patients. All patients received monodosis of antibiotic prophylactic with ciprofloxacin and metronidazol. Two patients (5.88%) had infection, because of that they received 7 days of antibiotics, resolving the infection completely. In 94% of the patients the anesthesia used was riding saddle subarachnoid blockade with hyperbaric bupivacaine, in all the cases the results were excellent. After surgery, 70% of the patients referred the pain as light, 20% as moderate and less than 10% as severe. Skin graft vitality was satifactory in100% of patients, 76% very go...