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LATERAL SPHINCTEROTOMY UP TO THE FISSURE APEX VERSUS TO LESS-THAN 1CM FROM ANAL VERGE IN CHRONIC ANAL-FISSURE IN FEMALES

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Last updated: 22 Jan 2023

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Abstract

Background: Lateral internal sphincterotomy is the ideal and gold standard surgical management of chronic anal fissure. The extent of lateral internal sphincterotomy is still         a subject of discussion. Excess division of the internal sphincter leading to incontinence either to stool or flatus, so we must determine the extent of sphincterotomy. Subjects and methods: Between the period from February  2018 and October  2018 in the General Surgery Department of Zagazig University and El – Ahrar teaching Hospitals, 62 female patients with chronic anal fissure  with mean ages of (34.1 + 8.2) and (41.8 + 9.05) of group A and B respectively complaining of chronic anal fissure. Group A of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy up to the fissure apex. Group B of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy to less than 1 cm from anal verge. Results: Group A showed complete fissure healing in 4 weeks  (25) patients (80.6%) with     (6 )patients cases comprising (19.35%) with delayed wound healing in 6 weeks .( 9 ) patients ( 29 % ) had transient incontinence to flatus . Group B showed complete fissure healing in 5 weeks  (20) patients (64.5%) with (11 )patients cases comprising (35.5%) with delayed wound healing in 6 weeks .( 2) patients ( 6 % ) had transient incontinence to flatus Conclusions: In females with chronic anal fissure, division of internal sphincter must not exceed 1 cm from anal verge and not reach apex of the fissure to preserve the internal sphincter function and prevent incontinence either to stool or to flatus.  

DOI

10.21608/ZUMJ.2019.26923

Keywords

chronicanal fissure, lateral internal sphincterotomy, stool incontinence, fissure healing

Authors

First Name

Beshoy

Last Name

Eskander

MiddleName

Tharwat

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Email

tharwat_beshoy@yahoo.com

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Orcid

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First Name

Abd El-Rahman

Last Name

Sadik

MiddleName

Hassan

Affiliation

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Orcid

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First Name

Abd El-Wahab

Last Name

Saleh

MiddleName

-

Affiliation

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Email

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City

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Orcid

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First Name

Hassan

Last Name

Saad

MiddleName

Awad

Affiliation

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Email

ebramos_2010@yahoo.com

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Volume

25

Article Issue

2

Related Issue

5034

Issue Date

2019-03-01

Receive Date

2019-03-01

Publish Date

2019-03-01

Page Start

227

Page End

233

Print ISSN

1110-1431

Online ISSN

2357-0717

Link

https://zumj.journals.ekb.eg/article_28192.html

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https://zumj.journals.ekb.eg/service?article_code=28192

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5

Type

Original Article

Type Code

273

Publication Type

Journal

Publication Title

Zagazig University Medical Journal

Publication Link

https://zumj.journals.ekb.eg/

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Article

Created At

22 Jan 2023