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Chronic fissure-in-ano: a randomized study comparing open and subcutaneous lateral internal sphincterotomy
J B Kortbeek1, J M Langevin, R E Khoo
1Holy Cross Hospital, Calgary, Alberta, Canada.
Diseases of the Colon and Rectum
|September 1, 1992
Summary
Subcutaneous lateral internal sphincterotomy offers comparable healing to open surgery for chronic anal fissures. This technique may reduce postoperative pain and hospital stays.
Area of Science:
- Colorectal Surgery
- Gastroenterology
Background:
- Chronic anal fissures are a common condition.
- Surgical intervention, specifically lateral internal sphincterotomy, is a treatment option.
Purpose of the Study:
- To compare the efficacy and outcomes of open versus subcutaneous lateral internal sphincterotomy for chronic anal fissure.
Main Methods:
- A prospective study randomized 112 patients with chronic anal fissure.
- Patients were assigned to either open (n=54) or subcutaneous (n=58) lateral internal sphincterotomy.
- Outcomes measured included acute complications, postoperative pain, length of stay, and fissure healing.
Main Results:
- No significant difference in acute complications between the two groups.
- Subcutaneous sphincterotomy resulted in a significantly shorter postoperative length of stay (1.7 vs. 2.3 days).
- Fissure healing rates were comparable (96.6% subcutaneous vs. 94.4% open), with trends suggesting less postoperative pain in the subcutaneous group.
Conclusions:
- Subcutaneous lateral internal sphincterotomy is an effective treatment for chronic anal fissure.
- The subcutaneous approach may offer advantages such as reduced postoperative discomfort and shorter hospital stays.
- Both open and subcutaneous techniques demonstrate comparable efficacy in healing chronic anal fissures.