Posterolateral versus lateral internal anal sphincterotomy in the treatment of chronic anal fissure: a randomized controlled trial

International Journal of Colorectal Disease
Mohammed AlawadyMohamed Farid

Abstract

Lateral internal anal sphincterotomy (LIS) is considered the treatment of choice for chronic anal fissure. This study aimed to compare the outcome of standard LIS and posterolateral internal sphincterotomy (PLIS) at 5 o'clock position as regards healing of anal fissure, improvement in symptoms, and complications. Patients with chronic anal fissure were randomly allocated to one of two groups; group I underwent PLIS and group II underwent LIS. Patients were compared regarding the duration of healing of anal fissure, improvement in anal pain as recorded by visual analogue scale (VAS), complications, particularly fecal incontinence (FI) and changes in the anal pressures. Eighty (49 females) patients were included to this trial. The mean age of patients was 35.5 years. The duration of healing was significantly shorter in group I than in group II (4.1 ± 1.7 vs 5.8 ± 1.4 weeks; p < 0.0001). Group I achieved significantly lower pain score at 1 month postoperatively than group II (1.1 ± 0.9 vs 1.7 ± 0.98; p = 0.005). Two (2.5%) of group I patients and six (10%) of group II patients experienced minor FI postoperatively. The postoperative reduction in the mean resting anal pressure in group I was significantly higher than that in group I...Continue Reading

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Citations

Jun 17, 2021·International Journal of Colorectal Disease·Konstantinos PerivoliotisKonstantinos Tepetes
Oct 15, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mahmoud AbdelnabySameh Hany Emile

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