Sphincterolysis: a novel approach towards chronic anal fissure.

BACKGROUND AND AIMS

The surgical approach in chronic anal fissure is often found associated with disturbed anal continence as well as recurrence. This report describes the author's approach of 'sphincterolysis' or fragmentation of the fibers of the internal sphincter on the left lateral anal wall.

PATIENTS AND METHODS

132 patients with chronic anal fissures were treated with this technique. Pre- and postoperative anal manometry was recorded. The postoperative course and early and 1-year follow-up results were recorded.

RESULTS

Early complications included ecchymosis, hematoma, and pain. Fissure healing and relief of symptoms observed in 97% of patients. A transient, variable degree of incontinence occurred in 23 patients and persistent incontinence to flatus and soiling in 5.

CONCLUSION

Internal anal sphincterolysis is a safe, effective procedure for the treatment of chronic anal fissure.