Lateral sphincterotomy for anal fissure: personal experience (2000–2002)

Objective The aim of the study was to evaluate the long-term results after lateral sphincterotomy for anal fissure for the period January 2000 to December 2002. Patients and methods Operated on were 46 patients (26 women and 20 men, age range 31–77, mean 50 years). In-hospital stay lasted 1 to 7 days, mean 1.8 days. Twenty-four patients (52.2%) were operated on under local, 17 (37%) under general, 3 (6.5%) under spinal and 2 (4.3%) under epidural anesthesia; 14 (30.4%) patients underwent simultaneous anorectal surgery. No complications occurred. All patients received a questionnaire by mail in February 2003. Results Of 46 patients, 28 (60.1%) responded, of them 27 (96.4%) were satisfied with the results of surgery and 1 (3.6%) was not. Twenty-one patients (75%) noted a full resolution of symptoms, 4 (14.2%) noted a minor anal discomfort and 3 (10.7%) a certain degree of anal pain and haemorrhage. Anal incontinence was present in 3 (10.7%) cases: according to Celveland Continence Score, 1 point in one case, 2 points in one case and 4 points in one case. Conclusions Lateral sphincterotomy was a safe and effective surgical option for anal fissure. As in some patients certain loss of anal control is unavoidable, conservative mesures should be administered prior to surgical treatment