Brief Reports
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 15, 2004; 10(16): 2412-2414
Published online Aug 15, 2004. doi: 10.3748/wjg.v10.i16.2412
Hypertrophied anal papillae and fibrous anal polyps, should they be removed during anal fissure surgery?
Pravin J. Gupta
Pravin J. Gupta, Proctologist, Gupta Nursing Home, D/9, Laxminagar, NAGPUR- 440022, India
Author contributions: All authors contributed equally to the work.
Correspondence to: Pravin J. Gupta, M.S., Proctologist, Gupta Nursing Home, D/9, Laxminagar, NAGPUR- 440022, India. drpjg@nagpur.dot.net.in
Received: July 12, 2003
Revised: January 12, 2004
Accepted: March 4, 2004
Published online: August 15, 2004
Abstract

AIM: Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures. The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus.

METHODS: Two groups of patients were studied. A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm. Another group of a hundred patients who also had papillae or fibrous polyps, were treated by lateral sphincterotomy alone. They were followed up for one year.

RESULTS: Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated. Group A patients showed a marked reduction with regard to pain and irritation during defecation (P = 0.0011), pricking or foreign body sensation in the anus (P = 0.0006) and pruritus or wetness around the anal verge (P = 0.0008).

CONCLUSION: Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure. This would add to effectiveness and completeness of the procedure.

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