Abstract

PEREZ PEREYRA, Julia; FRISANCHO VELARDE, Oscar; RUIZ BARAHONA, Edwin  and  PALOMINO, Américo. Fibroepithelial Lesions of the Anal Canal: therapeutic technique with Rubber band ligation. Rev. gastroenterol. Perú [online]. 2008, vol.28, n.1, pp.37-42. ISSN 1022-5129.

When fibroepithelial lesions of the anal canal increase in size and bleed, they can produce tenesmus and a sensation of a foreign body in the anus. Generally, these lesions are surgically excised. We present an original non-surgical technique using rubber band ligation. In the Gastroenterology Department of the "Edgardo Rebagliati Martins" National Hospital (EsSALUD) between June 2000, and June, 2007, 16 patients with anal fibroepithelioma were included: 6 men and 10 women, with an average age of 44, aged between 21 to 75, and 44% aged 20 to 29. All of these patients (100%) had anal tumors, 50% had prolapsus, 28% had anal pain and, 12% intermittent slight bleeding. The lesions had a polypoid appearance and sizes ranged from 1-5 cm. The technique consists in injecting 2% Xylocaine to the lesion, which is then retracted with surgical tweezers through the ring of the device holding the rubber band, which is then released leaving a safety margin of 5 to 10 mm over the skin. Biopsies of 11 lesions were taken and their analysis confirmed that there were 10 fibroepitheliomas and squamous epithelium. There was involution of the lesions due to ischemic necrosis in subsequent days. Patients only required oral analgesics for the first hours after procedure; only one patient presented an acute anal fissure. This non-surgical alternative performed on outpatient basis has proved to be effective and exempt from further complications.

Keywords : fibroepithelial polyp of the anus; anal fibroepithelioma; internal ligation.

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