Fissurectomy and Anocutaneous V-Y Flap in the Treatment of Chronic Anal Fissure: Clinical Experiences in Low Tone Cases

INTRODUCTION: Chronic anal fissure is a common condition that severely affects the quality of life. For patients who do not respond to medical and conservative treatments, alternative treatment methods such as fissurectomy and anocutaneous V-Y advancement flap application stand out. This study aims to evaluate the outcomes of 53 patients who underwent fissurectomy and anocutaneous V-Y advancement flap treatment as a sphincter-preserving method.
METHODS: This study includes 53 female cases conducted at the Department of General Surgery, Van Yüzüncü Yýl University Faculty of Medicine, between 2022 and 2024. Parameters such as demographic data (age, gender), number and type of deliveries, clinical features of chronic anal fissures, complications related to wound healing in the postoperative period, recurrence rates, and incontinence were examined.
RESULTS: The anocutaneous V-Y advancement flap was successfully applied to all 53 patients, and all patients recovered within an average of 45 days. Only six patients developed wound dehiscence, which was completely healed by the sixth month. At the end of the 12-month follow-up, no recurrence or incontinence was observed in any case.
DISCUSSION AND CONCLUSION: This study demonstrates that the anocutaneous V-Y advancement flap is an effective and safe method for treating chronic anal fissures in patients with low anal tone who have undergone multiple vaginal deliveries. Due to its high success rate, low complication risk, and ability to preserve anal continence, this method should be considered an important alternative in chronic anal fissure treatment.