Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure

Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure: A Randomized Clinical Trial

The present study aimed to compare the standard lateral internal sphincterotomy at 3 o'clock with posterolateral internal sphincterotomy at 5 o'clock in regards healing time, postoperative recurrence and complications, particularly fecal incontinence.

The present study aimed to compare the standard lateral internal sphincterotomy at 3 o'clock with posterolateral internal sphincterotomy at 5 o'clock in regards healing time, postoperative recurrence and complications, particularly fecal incontinence. We hypothesized that performing internal sphincterotomy in a point midway between the standard lateral position and the posterior midline position would confer better healing and relief of symptoms with less incidence of fecal incontinence while avoiding the development of keyhole deformity.

Inclusion Criteria:

• Adult patients of both genders with chronic posterior anal fissure were included to the study.

Exclusion Criteria:

• Patients with anterior or lateral anal fissure,
• patients with previous anal surgery,
• patients with concomitant anorectal pathology,
• patients with secondary anal fissure due to Crohn's disease or other specific etiology,
• patients with any degree of fecal incontinence,
• patients with active anorectal sepsis.