title: Lateral internal sphincterotomy for chronic idiopathic anal fissure: an alternative approach.
abstract: BACKGROUND
  An alternative approach to lateral internal sphincterotomy in the management of chronic anal fissure is presented and its potential advantages are described.
  
  
  METHODS
  Using the conventional diathermy, the internal sphincter along with its overlying anoderm is cut to the caudal border of the dentate line.
  
  
  RESULTS
  This prospective study included 350 patients. Twenty-six patients (7.4%) reported spotting of blood with defecation and 266 patients (76%) reported minimal perianal discharge. The cessation of the discharge and spotting of blood correlated with the complete healing of the sphincterotomy wound. Urine retention requiring temporary catheterization was encountered in 19 patients (5.4%). Neither abscesses nor fistulae were encountered. Cure was achieved in all patients. Neither recurrences nor permanent fecal incontinence were encountered throughout the study period.
  
  
  CONCLUSIONS
  The alternative approach is efficient and safe and may be added to the surgeon's armamentarium when attempting lateral internal sphincterotomy for chronic anal fissure.
authors.affiliation: Department of General Surgery, Faculty of Medicine, University of Alexandria, 20 Ismail Serry St., Semouha, Alexandria, Egypt. samerbessa@gmail.com
authors.forename: Samer Saad
authors.initials: SS
authors.lastname: Bessa
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D002908:Chronic Disease; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005401:Fissure in Ano / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult