Closed lateral internal sphincterotomy vs. anal sphincterolysis for chronic anal fissure: aprospective, randomized and control trial: LTP36

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Aim:The aim of this randomized,prospective study was to compare the results of closed lateral internal sphincterotomy with the author's innovative approach of finger fragmentation of internal sphincter fibres in the left lateral position termed as 'sphincterolysis' in the treatment of chronic anal fissure.Method:Patients with chronic anal fissures were randomly assigned to undergo closed lateral sphincterotomy or sphincterolysis. The patients were re-examined at 4 and 54 weeks. Postoperative pain, complications and fissure healing wereprospectively assessed.Results:One hundred and two patients were randomly assigned to either group. Eight patients developed complications in the post-operative period. Two patients from the sphincterolysis group had a perianal hematoma. Six patients in the sphincterotomy group had complications like bleeding and sepsis. At 4 weeks post-operatively fissures in 96% of patients in both groups had healed.Conclusion:Theprocedure of sphincterolysis seems to be equally effective when compared with closed sphincterotomy.

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