LATERAL SPHINCTEROTOMY UP TO THE FISSURE APEX VERSUS TO LESS-THAN 1CM FROM ANAL VERGE IN CHRONIC ANAL-FISSURE IN FEMALES | ||||
| Zagazig University Medical Journal | ||||
| Article 5, Volume 25, Issue 2, March 2019, Page 227-233 PDF (788.11 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ZUMJ.2019.26923 | ||||
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| Authors | ||||
Beshoy Tharwat Eskander; Abd El-Rahman Hassan Sadik; Abd El-Wahab Saleh; Hassan Awad Saad
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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. | ||||
| Keywords | ||||
| chronicanal fissure; lateral internal sphincterotomy; stool incontinence; fissure healing | ||||
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