Sphincterolysis: a novel approach towards chronic anal fissure.
OBJECTIVE
The surgical approach in chronic anal fissure is often found associated with disturbed anal continence as well as recurrence. This report describes the author's approach of 'sphincterolysis' or fragmentation of the fibers of the internal sphincter on the left lateral anal wall.


METHODS
132 patients with chronic anal fissures were treated with this technique. Pre- and postoperative anal manometry was recorded. The postoperative course and early and 1-year follow-up results were recorded.


RESULTS
Early complications included ecchymosis, hematoma, and pain. Fissure healing and relief of symptoms observed in 97% of patients. A transient, variable degree of incontinence occurred in 23 patients and persistent incontinence to flatus and soiling in 5.


CONCLUSIONS
Internal anal sphincterolysis is a safe, effective procedure for the treatment of chronic anal fissure.
Gupta
Pravin J
PJ
Gupta Nursing Home, Laxminagar, Nagpur, India. drpjg_ngp@sancharnet.in
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D002908:Chronic Disease; D004106:Dilatation / Q000379:methods*; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D005401:Fissure in Ano / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D011183:Postoperative Complications; D013514:Surgical Procedures, Operative