Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .
Chronic fissure-in-ano: A randomized study comparing open and subcutaneous lateral internal sphincterotomy
A prospect i ve study comparing open and subcutaneous lateral internal sphincterotomy for chronic anal fissure was conducted . One hundred twelve patients were r and omized to open ( n=54 ) or subcutaneous ( n=58 ) sphincterotomy . There was no significant difference in acute complications between the subcutaneous ( 8.6 percent ) and open ( 7.4 percent ) groups . Postoperative length of stay was significantly shorter for the subcutaneous group ( 1.7±0.2 days ) than for the open group ( 2.3±0.1 days;P<0.001 ) . Although the response rate to a pain question naire was < 50 percent , the data suggest a lower level of postoperative pain in the subcutaneous group . Fissure healing was similar between the subcutaneous ( 96.6 percent ) and open ( 94.4 percent ) groups . We conclude that subcutaneous lateral internal sphincterotomy for chronic fissure-in-ano is effective and may result in significantly less postoperative discomfort , shorter postoperative lengths of stay , and a comparable rate of complications compared with the open technique
Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .