[Treatment of chronic anal fissure with lateral sphincterotomy]

This paper presents a group of 134 patients, who underwent treatment of chronic anal fissure by internal lateral sphincterotomy (ILS) within the period of 12 years (1985-1996). This number of patients where those in whom conservative treatment (anal divulsion) was not successful. From the total number of 134 patients 110 were treated successfully by surgery (82.08%). In 19 patients even after fissure healing slight discomfort persisted. Moderate and more severe complaints were reported in 5 patients. In 4 cases the chronic anal fissure failed to heal, in 1 patient due to ILS perianal fistula developed. No other complications, like incontinency etc., were found within the short time interval of follow-up. ILS is a simple and safe surgical procedure performed under general anaesthesia after precise differentitation of the internal sphincter. The results of surgical treatment are very satisfactory, marked painfulness relieves immediately after operation, the fissure heals rapidly after relaxation of the internal sphincter spasm. Postoperative treatment is simple, the percentage of complications is low. None of the patients operated on in the authors department developed incontinence. (Tab. 3, Ref. 25.)