| Clinical Outcomes of Lateral Internal Sphincterotomy for Patients with Chronic Anal Fissure. |
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Park, Jung Soo , Lee, Jae Bum , Kim, Tae Sun , Cho, Hang Jun , Kim, Do Sun , Lee, Doo Han |
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Department of Surgery, Daehang Hospital, Seoul, Korea. dhlee@daehang.com |
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| Abstract |
PURPOSE
A lateral internal sphincterotomy (LIS) is a safe and effective surgical treatment that is the most commonly used one for patients with chronic anal fissure. However, reports on the recurrence rate and complications after LIS published in Korea are rare. The purpose of our study is to identify the types and rates of recurrence, the complications after LIS, and the differences in clinical outcomes between open and closed LIS.
RESULTS
We used hospital records and telephone interviews to study retrospectively the rates of recurrence and complications of 898 patients who underwent a LIS for chronic anal fissure from July, 2003, to June 30, 2004.
RESULTS
There were 292 male (mean age: 36.8 years, range: 16~84) and 606 female (mean age: 32.4 years, range: 1~68) patients. The preoperative mean maximum resting pressure in anal manommetry was 99.2 cmH2O in male patients and 97.7 cmH2O in female patients. Recurrence of fissure after LIS was present in five cases (0.6%). All underwent a LIS, on the same side of a previous LIS in four cases and on the opposite side in one case. Delayed healing of the fissure was present in six cases (0.7%). All of these patients were improved by conservative management. Complications of the LIS were thrombus formation, perianal abscess, fistula, and incontinence. Thrombus formation was present in eight cases (0.9%). Five patients underwent a thrombectomy and three patients were cured by conservative management. Perianal abscess or fistula was present in three patients (0.3%), who underwent incision and drainage or a simple fistulotomy.
Incontinence was present in two cases (0.2%). One patient was lost to follow up, and the other patient was improved by conservative management.
CONCLUSIONS
LIS is a safe and effective treatment for patients with chronic anal fissure, and recurrence and complications of LIS are rare. |
| Key Words:
Chronic anal fissure; Lateral internal sphincterotomy; Recurrence; Complication |
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