ArticleTechniques in coloproctology2023
Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissures: no advantages in terms of post-operative incontinence.
Article in Techniques in coloproctology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Outcome of lateral internal sphincterotomy for anal fissure in a retrospective cohort of patients.Updates in surgery · 2026Article
- Probe-Guided Intersphincteric Lateral Internal Sphincterotomy: A Modified Approach for Chronic Anal Fissures.Diseases of the colon and rectum · 2026Article
- Spectrum and Management of Anorectal Disorders: A Retrospective Analysis From the United Arab Emirates.Cureus · 2026Article
- Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders.Techniques in coloproctology · 2025Article
- Temporal trends and treatment patterns in anal fissure management: insights from a multicenter study in Italy.Techniques in coloproctology · 2024Article
- High-Intensity Laser Therapy - An Option for Managing the Pain in Anal Fissures.Journal of lasers in medical sciences · 2024Article
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9 authors.
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Abstract
purposeThe standard treatment for chronic anal fissures that have failed non-operative management is lateral internal sphincterotomy. Surgery can cause de novo incontinence. Fissurectomy has been proposed as a sphincter/saving procedure, especially in the presence of a deep posterior pouch with or without a crypt infection. This study investigated whether fissurectomy offers a benefit in terms of de novo post-operative incontinence.
methodsPatients surgically managed with fissurectomy or lateral internal sphincterotomy for chronic anal fissures from 2013 to 2019 have been included. Healing rate, changes in continence and patient satisfaction were investigated at long-term follow-up.
resultsOne hundred twenty patients (55 females, 65 males) were analysed: 29 patients underwent fissurectomy and 91 lateral internal sphincterotomy. Mean follow-up was 55 months [confidence interval (CI) 5-116 months]. Both techniques showed some rate of de novo post-operative incontinence (> +3 Vaizey score points): 8.9% lateral internal sphincterotomy, 17.8% fissurectomy (p = 0.338). The mean Vaizey score in these patients was 10.37 [standard deviation (sd) 6.3] after lateral internal sphincterotomy (LIS) and 5.4 (sd 2.3) after fissurectomy Healing rate was 97.8% in the lateral internal sphincterotomy group and 75.8% in the fissurectomy group (p = 0.001). In the lateral internal sphincterotomy group, patients with de novo post-op incontinence showed a statistically significant lower satisfaction rate (9.2 ± 1.57 versus 6.13 ± 3; p = 0.023) while no differences were present in the fissurectomy group (8.87 ± 1.69 versus 7.4 ± 1.14; p = 0.077).
conclusionsLateral internal sphincterotomy is confirmed as the preferred technique in term of healing rate. Fissurectomy did not offer a lower rate of de novo post-operative incontinence, but resulted in lower Vaizey scores in patients in whom this occurred. Satisfaction was lower in patients suffering a de novo post-operative incontinence after lateral internal sphincterotomy.
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