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Reappraisal of partial lateral internal sphincterotomy
B J Pernikoff1, T E Eisenstat, R J Rubin
1Division of Colon and Rectal Surgery, Muhlenberg Hospital UMDNJ-Robert Wood Johnson Affiliated Hospitals, Plainfield, New Jersey.
Diseases of the Colon and Rectum
|December 1, 1994
Summary
Partial lateral internal sphincterotomy offers a high success rate for chronic anal fissure treatment. Long-term follow-up reveals a low rate of impaired fecal continence, emphasizing patient selection and surgical technique.
Area of Science:
- Colorectal surgery
- Gastroenterology
- Surgical outcomes
Background:
- Chronic anal fissure is a common condition requiring effective treatment.
- Partial lateral internal sphincterotomy is a surgical option for refractory cases.
Purpose of the Study:
- To evaluate the long-term results, mortality, and morbidity of partial lateral internal sphincterotomy.
- To assess complication rates and patient satisfaction after this procedure.
Main Methods:
- Retrospective review of 500 patients undergoing the procedure between 1980 and 1990.
- Data collected from office surgical ledgers for patients diagnosed with anal fissure.
Main Results:
- A 1% failure rate and 2% recurrence rate were observed over a 5.6-year average follow-up.
- Minor complications occurred in 16% of patients; impaired fecal continence in 8%.
- Open sphincterotomy had higher complication rates (15%) than closed (8%).
Conclusions:
- Extended follow-up confirms the efficacy of partial lateral internal sphincterotomy.
- The 8% rate of impaired fecal continence is favorable compared to literature.
- High patient satisfaction (98%) is achievable with careful patient selection and surgical technique.