Tsodikov V. Clinical and morphological substantiation of treatment patients with anal fissure

The dissertation dedicates of treatment results increasing and quality of life improving by means of conservative treatment complement perfection and choice of surgical operation content patients with anal fissure. Found out gender differences in the thickness of lateral portions of internal anal sphincter (men have a hypertrophy and women have moderate atrophy), which are a scientific ground for contra-indication to implementation of lateral sphincterotomy for women. It is found out, that unsatisfactory results of treatment of patients with chronic anal fissure with complications as violation of act of defecation and anal sphincter spasm associated with absence in composition conservative therapy drug which selective takes off hypertone of anal sphincter. Unsatisfactory results of treatment of patients with chronic anal fissure as suppuration of postoperational wounds, incontinence, stricture of anal canal violation of act of defecation (19,2%) associated with the groundless choice of volume of operative interference in this category of patients. Is the necessity of including in the complement of conservative therapy of patients with acute anal fissure has been proved of drugs from the group of selective agonists of k-receptors and antagonists ?-receptors which isolated remove a spasm of internal anal sphincter. On the basis of correlation of signs of inflammation and processes of reparation patients selected by 3 periods: acute (to 6-7 months), subacute (from 8 to 11 months) and chronic (from 1 year and more). Scientifically grounded choice of place and depth of implementation of sphincterotomy for patients with chronic anal fissure and contra-indication for implementation of LST in women, and also certainly optimum term of implementation of anoplasty.