Review of outcome of closed versus open lateral internal partial sphincterotomy in the treatment of chronic anal fissure

Abstract EN

Background: Fissure in ano is a very common anal disorder which predominantly presents with sharp rectal pain and bleeding associated with bowel movements.

Partial lateral internal anal sphincterotomy is considered the preferred surgical treatment for chronic anal fissure; this may be performed using open or closed method, each with its complications.

This study compared the results and complications of closed versus open techniques of partial lateral internal anal sphincterotomy in patients with chronic anal fissure.

Materials and Methods: A total of 119 patients with chronic anal fissure were included in this study.

Of these 51 patients underwent closed partial lateral internal sphincterotomy and 68 patients underwent open partial lateral internal sphincterotomy.

All these patients were followed up for 6 months post – surgery.

The results and complications of both techniques were compared included pain, bleeding, infection, incontinence and recurrence rate.

Results: Pain, bleeding, infection and incontinence were less in the closed technique and in our study no patient by either technique became incontinent for faces, only few cases (Table 4) developed transient incontinence for flatus.

Conclusion: Closed partial lateral internal sphincterotomy technique is superior on open one in the surgical treatment of chronic anal fissures.