Subcutaneous lateral internal sphincterotomy in the treatment of chronic anal fissure

One hundred and seventeen patients with chronic anal fissure were submitted to subcutaneous internal lateral sphincterotomy. Immediate pain relief was observed in all patients except two, in whom sphincterotomy was incomplete. One hundred and ten patients had their first painless bowel movement 24 to 48 hours after the operation. Temporary incontinence to flatus was reported by 38 patients, whereas fecal incontinence was never observed. Healing time of the wound was six days, that of the fissure four weeks. In the 98 patients followed at six months and one year, no complications or recurrences were reported. If particular technical precautions are taken, this type of operation presents several advantages over other procedures, namely posterior midline sphincterotomy and anal stretching.