OBJECTIVE: Lateral internal sphincterotomy is an effective treatment for fissure in ano but carries a definite risk of incontinence. In trial to avoid this complication, segmental lateral internal sphincterotomy was used to treat chronic anal fissures. DESIGN: The lateral internal sphincterotomy was done in two parts and at different planes. SETTING: This study was conducted in the General Surgery Department, Zagazig University Hospital, Egypt. PATIENTS: This study was undertaken on 50 patients (43 men and seven women, with mean age of 37.3 years) with chronic fissure in ano from January 2009 to December 2010. INTERVENTIONS: Under general or local anesthesia, lateral internal sphincterotomy was done in two segments under direct vision. Preoperative and postoperative anal manometry study was recorded. MAIN OUTCOME MEASURES: Postoperative course with early and long-term results were recorded. Mean follow-up was 18.5 months (ranging from 6 to 24 months). RESULTS: In 31 patients, the technique was done under general anesthesia and the remainder under local anesthesia. The fissures and anal wounds were healed within 4 weeks. Pain was significantly reduced in all patients at day 1 postoperative. Early complications included mild hematoma and urine retention in one male patient (2%). No transient or any persistent degree of incontinence occurred in these patients group. CONCLUSION: Segmental lateral internal sphincterotomy is a safe, easy, and effective procedure and not associated with risk of incontinence for the treatment of chronic anal fissure.
OBJECTIVE: Lateral internal sphincterotomy is an effective treatment for fissure in ano but carries a definite risk of incontinence. In trial to avoid this complication, segmental lateral internal sphincterotomy was used to treat chronic anal fissures. DESIGN: The lateral internal sphincterotomy was done in two parts and at different planes. SETTING: This study was conducted in the General Surgery Department, Zagazig University Hospital, Egypt. PATIENTS: This study was undertaken on 50 patients (43 men and seven women, with mean age of 37.3 years) with chronic fissure in ano from January 2009 to December 2010. INTERVENTIONS: Under general or local anesthesia, lateral internal sphincterotomy was done in two segments under direct vision. Preoperative and postoperative anal manometry study was recorded. MAIN OUTCOME MEASURES: Postoperative course with early and long-term results were recorded. Mean follow-up was 18.5 months (ranging from 6 to 24 months). RESULTS: In 31 patients, the technique was done under general anesthesia and the remainder under local anesthesia. The fissures and anal wounds were healed within 4 weeks. Pain was significantly reduced in all patients at day 1 postoperative. Early complications included mild hematoma and urine retention in one male patient (2%). No transient or any persistent degree of incontinence occurred in these patients group. CONCLUSION: Segmental lateral internal sphincterotomy is a safe, easy, and effective procedure and not associated with risk of incontinence for the treatment of chronic anal fissure.
Authors: E García-Granero; A Sanahuja; S A García-Botello; O Faiz; P Esclápez; A Espí; B Flor; M Minguez; S Lledó Journal: Colorectal Dis Date: 2008-07-15 Impact factor: 3.788
Authors: Carl J Brown; Daniel Dubreuil; Laura Santoro; Maria Liu; Brenda I O'Connor; Robin S McLeod Journal: Dis Colon Rectum Date: 2007-04 Impact factor: 4.585