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Effect of lateral sphincterotomy on internal anal sphincter function. A computerized vector manometry study

N Williams1, N A Scott, M H Irving

  • 1Department of Surgery, University of Manchester, Hope Hospital, Salford, United Kingdom.

Diseases of the Colon and Rectum
|July 1, 1995
PubMed
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Lateral sphincterotomy (LS) effectively reduces high anal resting pressure in chronic anal fissure patients. The procedure also increases anal canal manometric asymmetry, indicating a segmental defect, aiding fissure healing.

Area of Science:

  • Colorectal surgery
  • Gastroenterology
  • Physiology

Background:

  • Chronic anal fissures are often associated with elevated internal anal sphincter pressure.
  • High resting pressure can impede blood flow and hinder fissure healing.

Purpose of the Study:

  • To evaluate the impact of lateral sphincterotomy (LS) on internal anal sphincter function in patients with chronic anal fissure.
  • To assess changes in anal resting pressure and manometric asymmetry post-LS.

Main Methods:

  • Prospective manometric study utilizing an eight-channel perfusion catheter.
  • Computerized data analysis of anal canal pressures before and after lateral sphincterotomy.

Main Results:

  • Patients with anal fissure had significantly higher mean resting pressure (85.1 mmHg) compared to controls (63.3 mmHg).

Related Experiment Videos

  • Lateral sphincterotomy significantly reduced mean resting pressure one week (50.0 mmHg) and five weeks (56.4 mmHg) post-procedure.
  • LS significantly increased anal canal manometric asymmetry at one (17.3%) and six weeks (11.7%) post-procedure.

    • Conclusions:

    • Lateral sphincterotomy effectively decreases anal canal resting pressure globally and symmetrically.
    • The procedure induces significant manometric asymmetry, suggesting the creation of a segmental defect that aids in fissure treatment.