Extent of Lateral Internal Sphincterotomy: Up to the Dentate Line or Up to the Fissure Apex?

Menteş, B. Bülent; Ege, Bahadır; Leventoğlu, Sezai; Oğuz, Mehmet; Karadag, A. Halide

doi:10.1007/s10350-004-0812-8

Cited by 72 publications

(61 citation statements)

References 23 publications

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“…This rate changes depending on operation technique and type and duration of postoperative follow up [11]. Mentes et al [12] carried out a prospective randomised study comparing Sphincterotomy Groups made either until fissure apex or dentate line and found that the rate of incontinence was higher in the Group where the incision was made until dentate line [12]. In a prospective randomised controlled study carried out by Valizedah et al [13] botilinum toxin injection and LIS were compared in the treatment of chronic anal fissure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Lateral Internal Sphincterotomy with Topical Nitroglycerine Treatment in Patients with Chronic Anal Fissure: A Prospective Randomised Study

Yetışır¹

2012

Surgery Curr Res

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Aim: Lateral Internal Sphincteromy (LIS) is considered as gold standard in the treatment of chronic anal fissure. However, LIS has complications such as gas and stool incontinence. The aim of the present study was to compare the results of LIS and 0.4% topical nitroglicerin treatment in patients with chronic anal fissure.Method: 150 patients with Chronic Anal Fissure were prospectively randomised into two Groups of 75 subjects in each. Group I underwent LIS and Group 2 was administered topical nitroglicerin. All patients were given high fibre diet and phsyllium diet before and after the treatment. After follow up period, two Groups were compared in terms of postoperative complications, recurrence rates, loss of work days and patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Comparison of Lateral Internal Sphincterotomy with Topical Nitroglycerine Treatment in Patients with Chronic Anal Fissure: A Prospective Randomised Study

Yetışır¹

2012

Surgery Curr Res

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“…[50] However, this comes with a higher overall treatment failure rate on longterm follow-up (13%) compared with a larger sphincterotomy either to the dentate line (0%) or to an anal diameter of 30mm (3%). [51], [52] Thus, a traditional, longer sphincterotomy, with fewer treatment failures and an acceptable rate of mild incontinence, appears to be the preferred technique.…”

Section: Division Of Internal Anal Sphinctermentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

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Anal fissure is one of the most common anorectal problems. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. There are many options to treat chronic fissures in ano. Some of them are non-surgical while the others are surgical. The efficacy claimed by each of the prevalent method is very high but the inconsistencies and contraindications are equally strong. To date, lateral sphincterotomy has been favoured by most of the proctologists, because it is the least extensive surgical procedure and is offering a long lasting relief in sphincter spasm. Various management technique are reviewed in this article along with Advancement flap for anterior fissure and a new method combining the age-old technique of Lord's manual dilatation followed by radio surgery is also highlighted along with their complications. The addition of radio surgery is found useful for refreshing the edges of the fissure and to tackle pathologies namely sentinel pile, small internal piles or hypertrophied anal papillae often found associated with chronic fissures. Revisiting the trends of treatment of chronic anal fissures, the most preferred options are the manual dilatation with radio surgery and the subcutaneous lateral anal sphincterotomy. Both methods are easy to perform, have negligible complications and no special setup is needed, except the radio surgical unit, in case of the first procedure.

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“…anorectal surgery, radiation or obstetrical trauma). To minimize this risk, several authors have tried a more limited division of internal sphincter, a tailored or controlled sphincterotomy [17,18]. Tailored sphincterotomy reduces the risk of incontinence, but may increase the incidence of recurrence [17,18].…”

Section: Discussionmentioning

confidence: 99%