{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:43:32Z","timestamp":1778629412115,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,2,19]],"date-time":"2009-02-19T00:00:00Z","timestamp":1235001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A proportion of patients with chronic anal fissure have persistent symptoms and pathology despite optimum conservative therapies. Lateral anal sphincterotomy, the standard surgical treatment, is associated with functional compromise in a minority of patients. Sphincter\u2010sparing anoplasty has been advocated as an alternative procedure for those with \u201clow pressure\u201d sphincters. The aim of this study was to determine the efficacy of simple cutaneous advancement flap anoplasty (SCAFA) when applied to consecutive patients with chronic anal fissure irrespective of anal tone and the patient\u2019s gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a prospective outcome study of 51 consecutive patients treated with SCAFA over a 6.5\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Surgery was well tolerated. There were three (5.9%) early flap dehiscences, all of which were treated with repeat SCAFA, and one of those three patients remained symptomatic at 2\u00a0months. All fissures healed in the short term. Three other patients subsequently developed fissures at sites remote from the original pathology. Continence was unaffected by the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Simple cutaneous advancement flap anoplasty should be considered as a first\u2010line surgical treatment of chronic anal fissure, irrespective of patient gender and anal tone.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-009-9937-1","type":"journal-article","created":{"date-parts":[[2009,2,18]],"date-time":"2009-02-18T16:07:32Z","timestamp":1234973252000},"page":"1058-1063","source":"Crossref","is-referenced-by-count":65,"title":["Simple Cutaneous Advancement Flap Anoplasty for Resistant Chronic Anal Fissure: A Prospective Study"],"prefix":"10.1002","volume":"33","author":[{"given":"Pasquale","family":"Giordano","sequence":"first","affiliation":[{"name":"Department of Surgery Whipps Cross University Hospital Whipps Cross Road E11 1NR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpiero","family":"Gravante","sequence":"additional","affiliation":[{"name":"Department of Surgery Whipps Cross University Hospital Whipps Cross Road E11 1NR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Grondona","sequence":"additional","affiliation":[{"name":"Department of Surgery Whipps Cross University Hospital Whipps Cross Road E11 1NR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Department of Surgery Whipps Cross University Hospital Whipps Cross Road E11 1NR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Porrett","sequence":"additional","affiliation":[{"name":"Department of Medical &amp; Surgical Gastroenterology Homerton Hospital Homerton Row E9 6SR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter James","family":"Lunniss","sequence":"additional","affiliation":[{"name":"Department of Medical &amp; Surgical Gastroenterology Homerton Hospital Homerton Row E9 6SR London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810949"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800830120"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889\u20108553(05)70172\u20102"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/003591576906200737"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800580204"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234220"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4531"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4980"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350\u2010004\u20100914\u20103"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.97.3.111"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007\u20101323.2001.01958.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010006\u20100261\u2010z"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807\u201059322005000100005"},{"key":"e_1_2_6_15_2","first-page":"526","article-title":"Anoplasty for stenosis and other anorectal defects","volume":"61","author":"Gonzalez AR","year":"1995","journal-title":"Am Surg"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-152-02-02"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02616758"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463\u20101318.2002.00373.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800820315"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010004\u20100663\u20108"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02053862"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463\u20101318.2003.00406.x"},{"key":"e_1_2_6_23_2","first-page":"CD003431","article-title":"Non surgical therapy for anal fissure","volume":"18","author":"Nelson R","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.34219"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.06.045"},{"key":"e_1_2_6_26_2","first-page":"CD002199","article-title":"Operative procedures for fissure in ano","volume":"18","author":"Nelson R","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350\u2010006\u20100844\u20103"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(97)09003\u2010X"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-009-9937-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-009-9937-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-009-9937-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:03:44Z","timestamp":1703603024000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-009-9937-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,2,19]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1007\/s00268-009-9937-1"],"URL":"https:\/\/doi.org\/10.1007\/s00268-009-9937-1","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,2,19]]}}}