Surgical Outcome and Complications of Lateral Internal Sphincterotomy in Chronic Anal Fissure- A Cross-sectional Study
PC06-PC08
Correspondence
Dr. Pooya Jalali,
Tabriz- University St, Tabriz, Iran (the Islamic Republic of), Iran.
E-mail: pooya.jalali1995@gmail.com
Introduction: Despite the advent of new methods in the conservative treatment of Chronic Anal Fissure (CAF), such as nitric oxide donors, they often require surgical treatment. The gold standard surgical option for the CAF is Lateral Internal Sphincterotomy (LIS). This procedure usually involves dividing the Internal Anal Sphincter (IAS) from the distal end to the fissure or dentate line (whichever comes first).
Aim: To evaluate the surgical outcome and complications of LIS in CAF.
Materials and Methods: This cross-sectional descriptive study was conducted on 60 patients with CAFs who underwent LIS in Imam Reza Hospital, Tabriz, Iran. The study was approved by the Ethical Committee of Tabriz University of Medical Sciences and was done from February 2017 to March 2019. The following data were recorded: age, sex, history of constipation, constipation duration, history of prolonged diarrhoea, child birth history, type of delivery, history of receiving pharmacological treatment for fissure, history of past fissure surgery, postoperative pain, postoperative complications and recurrence rates. The results were analysed using statistical methods (mean±Standard Deviation (SD)) for quantitative variables and frequencies and percentages for categorical variables.
Results: The mean age of the patients was 36.6±12 years (18- 70 years). During surgery, haemorrhoids, anal polyps, perianal fistulas, and anal masses were observed in 27 (45%), 7 (11.66%), 1 (1.6%), and 1 (1.6%) patients, respectively. After surgery, the patients’ symptoms decreased. Anal pain, bleeding and constipation decreased in 52 (86.67%), 50 (88.33%) and 43 (71.67%) patients respectively. Urinary retention, anal itching, and flatus incontinence were observed in 3 (5%), 1 (1.67%), and 9 (15%) patients, respectively. None of the patients had faecal incontinence and none had a recurrence. Complete healing was observed in all patients.
Conclusion: The LIS is an effective and safe option in the surgical treatment of patients with anal fissure.