Diseases of the Colon & Rectum

, Volume 38, Issue 1, pp 69–71 | Cite as

Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure

  • A. F. P. K. Leong
  • F. Seow-Choen
Original Contributions


PURPOSE: This study was designed to assess differences between lateral internal anal sphincterotomy and anal advancement flap for chronic anal fissure. METHODS: Forty patients with chronic anal fissure were prospectively studied. Patients randomized to the sphincterotomy group (n=20; median age, 34 (range, 16–61) years) underwent lateral internal anal sphincterotomy. Patients randomized to the flap group (n=20; median age, 32 (range, 20–44) years) had an anal advancement flap. RESULTS: All fissures in the sphincterotomy group healed following surgery compared with three patients that failed to heal in the flap group (P= 0.12). No patient in either group was incontinent to any degree following surgery. Patient satisfaction with surgery was similar in both groups. CONCLUSION: Anal advancement flap is an alternative to lateral sphincterotomy for chronic anal fissure.

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  1. 1.
    Lopez-Rios FL. Rhomboid flap in proctologic reconstruction. Dis Colon Rectum 1990;33:73–7.Google Scholar
  2. 2.
    Caplin DA, Kodner IJ. Repair of anal stricture and mucosal ectropion by simple flap procedures. Dis Colon Rectum 1986;29:92–4.Google Scholar
  3. 3.
    Peled IJ, Manny J, Wexler MR, Luttwak EM. The triangular island skin flap for treatment of anal ectropion. Dis Colon Rectum 1984;27:33–4.Google Scholar
  4. 4.
    Kaplan HY, Freund H, Muggia-Sullan M, Wexler MR. Surgical correction of ectropion of the anal mucosa. Surg Gynecol Obstet 1982;154:83–4.Google Scholar
  5. 5.
    Lewis TH, Corman ML, Prager ED, Robertson WG. Long-term results of open and closed sphincterotomy for anal fissure. Dis Colon Rectum 1988;31:368–71.Google Scholar
  6. 6.
    Walker WA, Rothenberger DA, Goldberg SM. Morbidity of internal sphincterotomy for anal fissure and stenosis. Dis Colon Rectum 1985;28:832–5.Google Scholar
  7. 7.
    Khubchandani IT, Reed JF. Sequalae of internal sphincterotomy for chronic fissure in ano. Br J Surg 1989;76:431–4.Google Scholar
  8. 8.
    Samson RB, Stewart WR. Sliding skin grafts in the treatment of anal fissures. Dis Colon Rectum 1970;13:372–5.Google Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1995

Authors and Affiliations

  • A. F. P. K. Leong
    • 1
  • F. Seow-Choen
    • 1
  1. 1.Department of Colorectal SurgerySingapore General HospitalSingaporeSingapore

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