Subcutaneous lateral internal sphincterotomy for chronic fissure-in-ano

Abstract

The results of subcutaneous lateral internal sphincterotomy for chronic fissure-in-ano were analyzed in a series of 60 patients operated upon over a period of two years. Immediate relief from pain with painless first bowel movement was accomplished in 97 per cent of the patients with very low morbidity rates. All patients were treated on an outpatient basis and had a minimum follow-up of two years without any recurrences. The incidence of sphincter dysfunction is very low and is usually only temporary.

Subcutaneous Fissurotomy: A Novel Procedure for Chronic Fissure-in-ano. A Review of 109 Cases

“…After internal sphincterotomy, persistence of anal fissures has been reported to be as high as 10 percent, which far exceeds the 1.8 percent recurrence rate in our series. [6][7][8][9]24 Despite these findings, internal sphincterotomy still has a role in treating those patients who experience recurrent symptoms after subcutaneous fissurotomy.…”

Controlled Lateral Sphincterotomy for Chronic Anal Fissure

“…Current surgical texts and articles have described the extent of division differently: to the level of the dentate line, 13 the lower one-third to one-half of the internal sphincter (just above the dentate line), 14 the dentate line, 15 the distal one-half of the internal sphincter, 7 and the lower two-thirds of the internal sphincter. 16 To overcome the incontinence risk of lateral internal sphincterotomy, surgeons have tried a more limited division of the internal sphincter. Littlejohn and Newstead 5 described a "tailored" lateral internal sphincterotomy.…”

Long–term assessment of fecal incontinence after lateral internal sphincterotomy

“…In most series, LIS permitted healing of fissure in more than 95% of cases. LIS is a simple procedure with low morbidity [10,14]. Recurrence or persistence of the fissure after surgery has been reported in less than 10% of cases [6,10,12].…”

“…Although, many studies have evaluated incontinence in the immediate postoperative period [6,8,9], only one report [10] has determined the incidence of fecal incontinence in the long-term outcome. The purpose of this study, therefore, was to perform a long-term assessment of fecal incontinence after LIS.…”