Long term outcomes of lateral internal sphincterotomy for the treatment of anal fissure. Coloproctology Division of Surgical Clinic 2, Maciel Hospital
Keywords:
lateral internal sphincterotomy, incontinence, relapseAbstract
Background: Sternal lateral sphincterotomy is the treatment of choice for anal fissure when medical treatment fails. It has a high success rate but as a counterpart can present up to 10% variable degrees of incontinence:
Objective: To evaluate the results of lateral lateral sphincterotomy in a series of patients with anal fissure.
Materials and methods: Twenty patients with anal fissure were evaluated in whom a lateral internal sphincterotomy was performed at one year. The evaluation was done by personal or telephone interview. Two aspects were fundamentally analyzed: relapse of the symptomatology and sphincter function.
Results: all patients were discharged within 24 hours postoperatively with low levels of postoperative pain, controlled with oral analgesics. Ten days postoperatively they did not present major complications or intense anal pain in any case. No recurrences of the anal fissure were found at one year after the patients were monitored. Fecal continence levels were perfect in 17 patients (Wexner score 0) and in 3 patients (15%) incontinence was detected for gases and exceptionally for liquid substances (score 5)
Discussion: Internal lateral sphincterotomy remains a safe option for the treatment of anal fissure, with high levels of cure and low sequelae in sphincter function, mainly affecting gas continence
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