A comparative study of the results of the anal fissurectomy and lateral internal sphincterotomy for chronic anal fissure
Abstract
Objective: To compare the results of surgical treatment of chronic anal fissure resistant to conservative management, after anal fissurectomy or lateral internal sphincterectomy.
Methodology: One hundred forty five patients with chronic anal fissure failed to heal with medical treatment admitted in the Department of Surgery Unit II Liaquat University Hospital Jamshoro Sindh Pakistan, from January 2007 to June 2009 were studied. Patients were divided into two groups, 67 patients underwent Fissurectomy (F), and 78 patients underwent open lateral internal sphinterotomy (LIS). We assessed the patients after median follow up of 12 months, for persistence of symptoms (pain, bleeding), complications and recurrence.
Results: All patients become symptoms free within 10 days of surgery. Urinary retention was noted in 3(2.06%) patients, 2(2.98%) in fissurectomy (F) and 1(1.28%) in lateral internal sphincterectomy (LIS) group. Incontinence to flatus was noted in 2(2.98%) patients of ‘F’ group and 1(1.28%) patient of ‘LIS’ group. Faecal soiling was noted only in 1(1.49%) patient of ‘F’ group. Recurrence occurred in 3(4.41%) patients of ‘F’ group, no recurrence seen in ‘LIS’ group. Wounds healed within six weeks. Sixty two (91.17%) patients of ‘F’ and 77(98.71) patients of ‘LIS’ group were satisfied with treatment.
Conclusion: In the treatment of chronic anal fissure lateral internal sphincterectomy is the best surgical technique with very few complications and better patient satisfaction.
Methodology: One hundred forty five patients with chronic anal fissure failed to heal with medical treatment admitted in the Department of Surgery Unit II Liaquat University Hospital Jamshoro Sindh Pakistan, from January 2007 to June 2009 were studied. Patients were divided into two groups, 67 patients underwent Fissurectomy (F), and 78 patients underwent open lateral internal sphinterotomy (LIS). We assessed the patients after median follow up of 12 months, for persistence of symptoms (pain, bleeding), complications and recurrence.
Results: All patients become symptoms free within 10 days of surgery. Urinary retention was noted in 3(2.06%) patients, 2(2.98%) in fissurectomy (F) and 1(1.28%) in lateral internal sphincterectomy (LIS) group. Incontinence to flatus was noted in 2(2.98%) patients of ‘F’ group and 1(1.28%) patient of ‘LIS’ group. Faecal soiling was noted only in 1(1.49%) patient of ‘F’ group. Recurrence occurred in 3(4.41%) patients of ‘F’ group, no recurrence seen in ‘LIS’ group. Wounds healed within six weeks. Sixty two (91.17%) patients of ‘F’ and 77(98.71) patients of ‘LIS’ group were satisfied with treatment.
Conclusion: In the treatment of chronic anal fissure lateral internal sphincterectomy is the best surgical technique with very few complications and better patient satisfaction.
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