[Fissure-in-ano. Alterations in continence and quality of life during disease and at six months after lateral subcutaneous internal sphincterotomy].
OBJECTIVE
To prospectively evaluate alterations in continence and quality of life produced by lateral internal sphincterotomy with each patient acting as his or her own control.


METHODS
Quality of life (SF-36 questionnaire) and fecal incontinence (Cleveland Clinic Florida-Fecal Incontinence [CCF-FI] questionnaire) were evaluated before and 6 months after lateral internal sphincterotomy was performed in 113 consecutive patients diagnosed with chronic anal fissure.


RESULTS
Four patients were excluded because of their inability to complete the SF-36 questionnaire without help. Of the 109 remaining patients, there was persistence or relapse of anal fissure in six (5.5%). One patient refused to complete the quality of life questionnaire again and was excluded from the study. Of the 108 patients who completed the study, the median (interquartile range) score in the CCF-FI scale increased from 0.00 (3) before the intervention to 1(4) in the postoperative period (p = 0.001). Quality of life significantly improved after the operation, since the scores of the following scales increased: physical functioning (p = 0,005), role limitations-physical (p = 0.006), bodily pain (p < 0.001), vitality (p = 0.008), social functioning (p = 0.022) and mental health (p < 0.001). No statistically significant differences were found in general health perception or in role limitations-emotional.


CONCLUSIONS
Despite deterioration in continence, sphincterotomy improves quality of life in patients with anal fissure.
Ortiz
Héctor
H
Unidad de Coloproctología, Servicio de Cirugía, Hospital Virgen del Camino, Pamplona, Navarra, España. hortizhu@cfnavarra.es
Marzo
José
J
Armendáriz
Pedro
P
DeMiguel
Mario
M
Blasi
Medel L
ML
D000328:Adult; D000368:Aged; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods; D005242:Fecal Incontinence; D005260:Female; D005401:Fissure in Ano / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors