Closed lateral subcutaneous sphincterotomy under local anaesthesia in the treatment of chronic anal fissure.

We studied 65 consecutive ambulatory patients with chronic anal fissure that were treated by sphincterotomy under local anaesthesia. The patients were allowed to leave the clinic immediately after the operation. Healing rate was determined three to four months postoperatively by clinical examination and proctoscopy. Fifty-seven patients (88%) were free of symptoms and the fissure was healed. Eight unhealed patients were subjected to a repeated procedure under local anaesthesia, leaving two unhealed patients, that were operated with open sphincterotomy under general anaesthesia. We conclude that local anaesthesia can be recommended for the closed lateral subcutaneous sphincterotomy in ambulatory treatment of chronic anal fissure.