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Total lateral sphincterotomy for anal fissure

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Initial experience with the posterior sphincterotomy for treating anal fissures was unsatisfactory, with a significant rate of recurrences and anal incontinence. This report describes the lateral approach to complete section of the internal sphincter.

Patients and methods

Between 1997 and 2001 we surgically treated 164 patients for anal fissure. Preoperative and postoperative anal manometries were recorded. Postoperative course and early and long-term results were recorded.

Results

No fissure failed to heal. Early complications included bleeding, hematoma, and pain. A transient, variable degree of incontinence occurred in 15 patients and persistent incontinence to flatus and soiling in 5. After total sphincterotomy no long-term complication was observed. Patient satisfaction was 96%.

Conclusion

Total subcutaneous, internal sphincterotomy is a safe, effective procedure for the treatment of chronic anal fissure.

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Authors and Affiliations

  1. First Department of Surgery, Medical School, University of Rome "La Sapienza", Viale del Policlinico 155, 00161, Rome, Italy

    Adriano Tocchi, Gianluca Mazzoni, Michelangelo Miccini, Diletta Cassini, Elia Bettelli & Stefania Brozzetti

  2. Via Bruno Bruni 94, 00189, Rome, Italy

    Adriano Tocchi

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  1. Adriano Tocchi
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  2. Gianluca Mazzoni
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  3. Michelangelo Miccini
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  4. Diletta Cassini
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  5. Elia Bettelli
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  6. Stefania Brozzetti
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Correspondence to Adriano Tocchi.

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Tocchi, A., Mazzoni, G., Miccini, M. et al. Total lateral sphincterotomy for anal fissure. Int J Colorectal Dis 19, 245–249 (2004). https://doi.org/10.1007/s00384-003-0525-9

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  • DOI: https://doi.org/10.1007/s00384-003-0525-9

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