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Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure
1Department of Colorectal Surgery, Singapore General Hospital.
Purpose:
This study was designed to assess differences between lateral internal anal sphincterotomy and anal advancement flap for chronic anal fissure.
Methods:
Forty patients with chronic anal fissure were prospectively studied. Patients randomized to the sphincterotomy group (n = 20; median age, 34 (range, 16-61) years) underwent lateral internal anal sphincterotomy. Patients randomized to the flap group (n = 20; median age, 32 (range, 20-44) years) had an anal advancement flap.
Results:
All fissures in the sphincterotomy group healed following surgery compared with three patients that failed to heal in the flap group (P = 0.12). No patient in either group was incontinent to any degree following surgery. Patient satisfaction with surgery was similar in both groups.
Conclusion:
Anal advancement flap is an alternative to lateral sphincterotomy for chronic anal fissure.