BACKGROUND AND AIMS: Initial experience with the posterior sphincterotomy for treating anal fissures was unsatisfactory, with a significant rate of recurrences and anal incontinence. This report describes the lateral approach to complete section of the internal sphincter. PATIENTS AND METHODS: Between 1997 and 2001 we surgically treated 164 patients for anal fissure. Preoperative and postoperative anal manometries were recorded. Postoperative course and early and long-term results were recorded. RESULTS: No fissure failed to heal. Early complications included bleeding, hematoma, and pain. A transient, variable degree of incontinence occurred in 15 patients and persistent incontinence to flatus and soiling in 5. After total sphincterotomy no long-term complication was observed. Patient satisfaction was 96%. CONCLUSION: Total subcutaneous, internal sphincterotomy is a safe, effective procedure for the treatment of chronic anal fissure.
BACKGROUND AND AIMS: Initial experience with the posterior sphincterotomy for treating anal fissures was unsatisfactory, with a significant rate of recurrences and anal incontinence. This report describes the lateral approach to complete section of the internal sphincter. PATIENTS AND METHODS: Between 1997 and 2001 we surgically treated 164 patients for anal fissure. Preoperative and postoperative anal manometries were recorded. Postoperative course and early and long-term results were recorded. RESULTS: No fissure failed to heal. Early complications included bleeding, hematoma, and pain. A transient, variable degree of incontinence occurred in 15 patients and persistent incontinence to flatus and soiling in 5. After total sphincterotomy no long-term complication was observed. Patient satisfaction was 96%. CONCLUSION: Total subcutaneous, internal sphincterotomy is a safe, effective procedure for the treatment of chronic anal fissure.
Authors: M Marby; J Alexander-Williams; P Buchmann; Y Arabi; A Kappas; S Minervini; D Gatehouse; M R Keighley Journal: Dis Colon Rectum Date: 1979 Jul-Aug Impact factor: 4.585