Skip to main content

Advertisement

SpringerLink
Log in

Results of Lateral Internal Sphincterotomy with Open Technique for Chronic Anal Fissure: Evaluation of Complications, Symptom Relief, and Incontinence with Long-Term Follow-Up

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The aim of this study is to investigate the results of open lateral internal sphincterotomy (LIS) and the recurrence and incontinence rate, to perform a long-term assessment of incontinence and to assess complications and relief of symptoms. This clinical prospective study was undertaken in patients undergoing open LIS. One hundred and twenty-nine patients entered the study. Mean duration of pain relief was 1.2 ± 0.4 days and mean time before defecation without pain was 1.9 ± 1.0 days. Complication rate was 41.8%. We found that urine retention was seen frequently in males. We demonstrated that open LIS up to the dentate line does not have a higher rate of incontinence. Incontinence after LIS was only to flatus and two-thirds of these resolved in 6 weeks. No patient showed improvement of incontinence after 6 weeks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Griffin N, Acheson AG, Tung P, et al. Quality of life in patients with chronic anal fissure. Colorectal Dis. 2003;6:39–44. doi:10.1111/j.1463-1318.2004.00576.x.

    Article  Google Scholar 

  2. Garcea G, Sutton C, Mansoori S, et al. Results following conservative lateral sphincterotomy for the treatment of chronic anal fissure. Colorectal Dis. 2002;5:311–314. doi:10.1046/j.1463-1318.2003.00465.x.

    Article  Google Scholar 

  3. Steele SR, Madoff RD. Systematic review: treatment of anal fissure. Aliment Pharmacol Ther. 2006;24:247–257. doi:10.1111/j.1365-2036.2006.02990.x.

    Article  PubMed  CAS  Google Scholar 

  4. Ammari FF, Bani-Hani KE. Faecal incontinence in patients with ananl fissure: a consequence of internal sphincterotomy or a feature of a condition? Surg J R Coll Surg. 2004;2:225–229.

    CAS  Google Scholar 

  5. Liratzopoulos N, Efremidou EI, Papageorgiou MS, et al. Lateral subcutaneous internal sphincterotomy in the treatment of chronic anal fissure: oue experience in 246 patients. J Gastrointest Liver Dis. 2006;15(2):143–147.

    Google Scholar 

  6. Rotholtz NA, Bun M, Mauri MV, et al. Long-term assessment of fecal incontinence after lateral internal sphincterotomy. Tech Coloproctol. 2005;9:115–118. doi:10.1007/s10151-005-0208-3.

    Article  PubMed  CAS  Google Scholar 

  7. Menteş B, Ege B, Leventoğlu S, et al. Extent of lateral internal sphincterotomy: up to the dentate line or up to the fissure apex? Dis Colon Rectum. 2005;48:365–370. doi:10.1007/s10350-004-0812-8.

    Article  PubMed  Google Scholar 

  8. Menteş BB, Tezcaner T, Yılmaz U, et al. Results of lateral internal sphincterotomy for chronic anal fissure with particular reference to quality of life. Dis Colon Rectum. 2005;49:1046–1051.

    Google Scholar 

  9. Dong-Yoon C. Controlled lateral sphincterotomy for chronic anal fissure. Dis Colon Rectum. 2005;48:1037–1041. doi:10.1007/s10350-004-0867-6.

    Article  Google Scholar 

  10. Nelson RL. A systematic review of medical therapy for anal fissure. Dis Colon Rectum. 2004;47:422–431. doi:10.1007/s10350-003-0079-5.

    Article  PubMed  Google Scholar 

  11. Hyman N. Incontinence after lateral internal sphincterotomy: a prospective study and quality of life assessment. Dis Colon Rectum. 2004;47:35–38. doi:10.1007/s10350-003-0002-0.

    Article  PubMed  Google Scholar 

  12. Menteş BB, Tezcaner T, Yılmaz U, et al. Results of internal sphincterotomy for chronic anal fissure with particular reference to quality of life. Dis Colon Rectum. 2006;49:1045–1051. doi:10.1007/s10350-006-0527-0.

    Article  PubMed  Google Scholar 

  13. Wiley M, Day P, Rieger N, et al. Open vs closed lateral internal sphincterotomy for idiopathic fissure-in-ano: a prospective, randomized, controlled trial. Dis Colon Rectum. 2004;47:847–852. doi:10.1007/s10350-004-0530-2.

    Article  PubMed  CAS  Google Scholar 

  14. Ayantunde AA, Debrah SA. Current concepts in anal fissures. World J Surg. 2006;30:2246–2260. doi:10.1007/s00268-005-0664-y.

    Article  PubMed  Google Scholar 

  15. Romero AS, Sebastian AA, Vicente EP, et al. Open lateral internal anal sphincterotomy under local anesthesia as the gold Standard in the treatment of chronic anal fissures. A prospective clinical and manometric study. Rev Esp Enferm Dig. 2004;96:856–863.

    Google Scholar 

  16. Ortiz H, Marzo J, Armendariz P, et al. Quality of life assessment in patients with chronic anal fissure after lateral sphincterotomy. Br J Surg. 2005;92:881–885. doi:10.1002/bjs.4980.

    Article  PubMed  CAS  Google Scholar 

  17. Nyam DC, Pemberton JH. Long-term results of lateral internal sphincterotomyfor chronic anal fissurewith particular reference to incidence of fecal incidence. Dis Colon Rectum. 1999;42:1306–1310. doi:10.1007/BF02234220.

    Article  PubMed  CAS  Google Scholar 

  18. Lewis TH, Corman MI, Prager ED, et al. Long term results of open and closed sphincterotomy for anal fissure. Dis Colon Rectum. 1988;31:368–371. doi:10.1007/BF02564886.

    Article  PubMed  CAS  Google Scholar 

  19. Elsebae MMA. A study of fecal incontinence in patients with chronic anal fissure: prospective, randomized, controlled trial of the extent of internal anal sphincter division during lateral sphincterotomy. World J Surg. 2007;31:2052–2057. doi:10.1007/s00268-007-9177-1.

    Article  PubMed  Google Scholar 

  20. Zbar AP, Gabel MB, Chiappa AC, et al. Fecal incontinence after minor anorectal surgery. Dis Colon Rectum. 2001;44:1610–1623. doi:10.1007/BF02234380.

    Article  PubMed  CAS  Google Scholar 

  21. Casillas S, hull TL, Zutshi MZ, et al. Incontinence after a lateral internal sphincterotomy: are we underestimated it? Dis Colon Rectum. 2005;48:1193–1199. doi:10.1007/s10350-004-0914-3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. General Surgery Department, Ankara Atatürk Teaching and Research Hospital, Bilkent, Ankara, 06800, Turkey

    Gülten Kiyak, Birol Korukluoğlu, Ahmet Kuşdemir, Ibrahim Çağatay Şişman & Emre Ergül

  2. 34. cadde 400.sokak 17/8, Yüzüncüyil, Ankara, 06530, Turkey

    Gülten Kiyak

Authors
  1. Gülten Kiyak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Birol Korukluoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmet Kuşdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ibrahim Çağatay Şişman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emre Ergül
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gülten Kiyak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kiyak, G., Korukluoğlu, B., Kuşdemir, A. et al. Results of Lateral Internal Sphincterotomy with Open Technique for Chronic Anal Fissure: Evaluation of Complications, Symptom Relief, and Incontinence with Long-Term Follow-Up. Dig Dis Sci 54, 2220–2224 (2009). https://doi.org/10.1007/s10620-008-0621-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0621-3

Keywords

Search

Navigation