Total Lateral Sphincterotomy For Anal Fissure

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DOI: 10.7860/JCDR/2013/7656.3698 Original Article Study of

Anal fissure is a common anal pathology that causes significant morbidity in the population. It may be acute or chronic. It may be treated medically or surgically. This is a retrospective analysis of admitted and operated patients of anal fissure by lateral anal internal sphincterotomy either by open

Anal Surgery and Colon and Rectal Surgery

Fissure (Tear) Fissurectomy Only done for chronic fissure il lf hih lliinvolves removal of scar which usually is a heaping of tissue called a sentinel pile often inside and outside Sphincterotomy division of only the internal anal sphincter not the external caninternal anal sphincter not the external can be done open or closed

The effect of lateral internal sphincterotomy on resting anal

anal fissure and sentinel pile on physical examination were defined as chronic anal fissure. The resting anal pressures of both groups were measured by rectal manometer prior to operation and 6 months after surgery. 2.1. Lateral internal sphincterotomy All of the patients were operated on by the same surgeon in a standardized technique.


(using 2% diltiazem) and lateral internal sphincterotomy for chronic anal fissure a dissertation submitted to the tamilnadu dr mgr medical university chennai in partial fulfillment of the requirement for the degree of m.s. (general surgery) branch - i department of general surgery tirunelveli medical college tirunelveli- 11 may 2019

Needle-in-Groove Technique: A Safer Modification for

Anal fissure is a longitudinal split of the anal canal mucosa and anoderm, extending usually from dentate line to the external verge of the anal canal and was recognized as a clinical entity in 1934 [1]. The cause of anal fissure is controversial although it has been recognized that anal fissures are probably caused by internal anal sphincter

The technique of combined fissurectomy and posterior internal

lateral internal sphincterotomy among patients with chronic anal fissure, also reported 2(6.2%) cases of flatus incontinence and one (3.1%) case of fissure recurrence in the fissurectomy group, but none in the lateral internal sphincterotomy group (Mousavi et al., 2009). Both groups were healed satisfactorily within 8 weeks without wound


lateral internal sphincterotomy against the sphincterotomy as primary treatment modality for chronic anal fissure. Th is pr osec tve andm z d u y w t I a U H l, Hyderabad between November 2004 and October 2005. Fifty patients fulfilling the criteria were randomised into two equal groups.

Dermal Flap Advancement Combined with Conservative

Lateral internal sphincterotomy (LIS) is considered the surgical treatment of choice for chronic anal fissure (CAF). Flap techniques for fissure coverage have the advantage of primary wound healing, potentially providing better functional results and faster pain relief. The standard surgical strategy

Open versus closed lateral internal anal sphincterotomy in

A total of 136 patients were randomly assigned to each of two groups. or lateral internal sphincterotomy. Finger anal dilatation is Fissure position Anterior


trolled trial. A total of 62 patients aged 15 to 65 with anal fissure complaints were randomly selected for lateral in-ternal sphincterotomy (LIS) in a referral Colorectal Center in Baqiyatallah Hospital between March 2004 and De-cember 2004 in Tehran Iran. The rational for limiting age was the contraindication of using some anesthetic agent in

A comparative study of the results of the anal fissurectomy

Anal fissurectomy vs. lateral internal sphincterotomy for chronic anal fissure Pak J Med Sci 2012 Vol. 28 No. 1 113 midline.5 Atypical anal fissure can occur any where in anal canal and these re associated with other diseases (Crohn s disease, HIV infection, cancer, syphilis, and Tuberculosis). Anterior anal fissure


Anal fissure is a common and painful disorder. Its relation to hypertonic anal sphincter is controversial. The most common surgical treatment of chronic anal fissure is lateral internal sphincterotomy either open or closed methods, associated with a risk of pain, bleeding, recurrence and incontinence.

Outcome of Lateral Internal Sphincterotomy in the Management

Keywords: Outcome, Lateral, Internal, Sphincterotomy, Management, Chronic, Fissure, Anal Introduction Small tears in the skin of the anus are termed as anal fissures. Anal fissures usually occur in the squamous epithelium of the anal skin that extends up to the anal margin 1. Fissure in ano are a commonly found disease which in its severe form

Anal fissure - The CLEATOR CLINIC

lateral sphincterotomy (cutting part of the muscle that controls leakage from the anus) under general anesthesia being favored over anal dilation. After lateral sphincterotomy there is a 10% recurrence rate and 10% risk of some leakage of mucus or stool. Anal dilation (stretching the muscle that controls leakage form the anus under anesthesia)

Surgical Treatment of Anal Fissures: Population and Outcomes

The treatment of anal fissure has been evolving and with this work we realize that anal fissure surgery can be safely performed on an outpatient basis respecting the dignity and comfort of the patient. Keywords: Anal fissure; Proctologic surgery; Lateral internal sphincterotomy; Fissurectomy; V-Y anoplasty. Wilson Malta. 1 *, Teresa Correia. 1

Minimal Lateral Internal Sphincterotomy (LIS): Is It Enough

chronic anal fissure: lower incidence of anal incontinence com-pared to lateral internal sphincterotomy after long-term follow-up. Dis Colon Rectum 2010;53:1563-8. 6. Menteş BB, Tezcaner T, Yilmaz U, Leventoğlu S, Oguz M. Results of lateral internal sphincterotomy for chronic anal fissure with particular reference to quality of life.

Fissurectomy with Posterior Midline Sphincterotomy for

anal fissure. In addition, unlike lateral sphincterotomy, the incision of the internal sphincter is more controlled and through the same scar instead of creating a new one. REFERENCES 1. Lund JN. Nitric oxide deficiency in the internal anal sphincter of patients with chronic anal fissure. Int J Colorectal Dis2006; 21: 673-5. Epub 2005 Jul 29. 2.

Closed versus open lateral internal anal sphincterotomy in a

Closed versus open lateral internal anal sphincterotomy in a chronic anal fissure Anandaravi B. N., Ramaswami B.* Accepted: recurrence INTRODUCTION Anal fissure is a common proctological problem, which presents with pain in the anal region during and after defecation. Anal fissure is a linear tear at the anal verge.


sphincterotomy is performed at location away from the fissure, lateral from it, using open or closed technique (6,20). Metaanalysis of the results of the treatment of 2727 patients with chronic anal fissures showed that the lateral sphincterotomy gives better outcomes compared to anal dilatation.

Comparison of Wound Complications in Open vs Closed Lateral

Chronic fissure-in-ano: a randomized study comparing open and subcutaneous lateral internal sphincterotomy. Dis Colon Rectum. Sept 1992; 35(9): 835-7 5. Gupta V, Rodrigues G, Prabhu R, Ravi C. Open versus closed lateral internal sphincterotomy in the management of chronic anal fissures: a prospective randomized study. Asian J Surg. 2014; 37(4

Comparative Study of Lateral Sphincterotomy and Local

sphincter tone is surgery. Lateral internal sphincterotomy is the golden standard in the treatment of chronic anal fissures.1-3 It involves partial division of the internal anal sphincter away from the fissure. Calcium channel blockers have been shown to lower resting anal pressure and promote fissure healing. 4,5 In the present study,


fissure in 33.3% was noted with topical treatment while lateral internal sphincterotomy relieved 100% of cases. Surgery for anal fissure is associated with several complications, most of which can be prevented by the use of judicious surgical techniques and, of course, by familiarity with anorectal anatomy.

Hareesh G. S. R., Padmanabham Somangurthy*

for anal fissure, manual anal dilatation (MAD) and lateral internal anal sphincterotomy (LAS). Methods: This is a prospective cohort study comparing MAD and LAS in the treatment of chronic anal fissure at Sri Venkateswara Medical College, Tirupati, from December 2017 to December 2018. A total of 60 patients who met

Long Term Sphincter Function after Lateral Internal

A total of 250 patients underwent lateral internal sphincterotomy for chronic anal fissure performed by a single surgeon during the study period between the years 2004 to 2010. One-hundred and ten patients were not contactable. Eighty-one patients were excluded; 66 patients underwent LIS together with haemorrhoidectomy and 11


Conclusion: Lateral Internal Sphincterotomy may be regarded as treatment of choice in the management of chronic anal fissure where as 2% Diltiazem can be used in elderly patients and those who refused surgery. KEYWORDS Anal fissure, Diltiazem, Lateral internal sphincterotomy Introduction An anal fissure is a painful linear tear situated in

ENGIGRARLANIGIRO Close Lateral Internal Sphincterotomy, an

2017 to March 2019. Total 120 patients with chronic anal fissure, fulfilling the inclusion criteria, were selected. Close lateral internal sphincterotomy was done in all patients. Results were obtained and analyzed using SPSS version 15. Results: Out of 120 patients, male and female patients were 84(70%) and 36(30%). Age was ranging from 20 to

Anal fissure - The CLEATOR CLINIC

fails the patient can be referred for surgery, lateral sphincterotomy (cutting part of the muscle that controls leakage from the anus) under general anesthesia being favored over anal dilation. After lateral sphincterotomy there is a 10% recurrence rate and 10% risk of some leakage of mucus or stool. Anal dilation (stretching the muscle that

Lateral Internal Sphincterotomy Versus Chemical

showed 98% healing of anal fissure with lateral internal sphincterotomy while GTN relieved 56%, with 10% recurrence.14 In another local study, fissure healing was found in 66.7% with side effect of headache and a recurrence rate of 25% within six months of topical GTN.15 Other studies have shown healing rate upto 70% with GTN.6,8,16

Medical Journal of Clinical Trials & Case Studies

Background/ Aims: Anal fissure is a common problem that causes significant morbidity in a young population. Surgical techniques like manual anal dilatation or lateral internal sphincterotomy, effectively heals most fissures but may result in anal continence.

Open Versus Closed Lateral Internal Sphincterotomy in Chronic

sphincterotomy in patients with chronic anal fissure. Materials and Methods: A total of 64patients with chronic anal fissure were enrolled in this study. Of these, 34patients underwent open lateral sphincterotomy, and 30 underwent closed sphincterotomy. They were followed up for 6 months postsurgery. The results and complications of the two

Archives of Clinical Gastroenterology

Management of Chronic Anal Fissure. Arch Clin Gastroenterol 2(1): 013-016. DOI: 10.17352/2455-2283.000013. 013. Abstract. Aims and Objectives: To. prospectively evaluate and compare effectiveness of topical 0.2% glyceryl trinitrate ointment vs lateral internal sphincterotomy in treatment of patients with chronic anal fissure. Material and Methods

Bilateral versus unilateral botulinum toxin injections for

allowing healing of the fissure. Success rates (65 75%) are significantly lower than those associated with surgical sphincterotomy [2 , 10]. BT is an endopeptidase which blocks acetylcholine release at the neuromuscular junction. However, in the treat-ment of anal fissure the main effect of BT is by blockade of

Chronic Anal Fissure: A Comparative Study of Medical

anal fissure since last decade (1). Medical treatment, as not injuring the anal sphincter, and being non-invasive, is presumed as the first option (3,5,8-10). But surgical sphincterotomy remains the gold standard for treatment of anal fissure (6,7,11). Mostly used medications are diltiazem, nitric oxide derivatives, and botulinum toxin injections

Comparison of Anal Manometric Pressure in patients with

Aim: Anal fissure constitutes around 10-15% of consultation in proctology clinics. It is the most common cause of anal pain, bleeding Lateral internal sphincterotomy is the gold standard treatment, and significant reduction in anal pressure noted among these patients

Anal fissure: Over 30 years experience

Anal fissure: Over 30 years experience Lacitignola Sebastiano* and Manzo Fabio Department of General Surgery, Clinica Bernardini, Taranto, Italy Abstract Background: Chronic Anal Fissure (CAF) is a common benign condition that reduces the quality of life. Lateral internal sphincterotomy (LIS) is frequently carried

Research Article Open Access Chronic Anal Fissure - A Multi

Conclusion: Lateral sphincterotomy is safe and effective surgical management for chronic anal fissure with minimal postoperative complications. Keywords: Chronic anal fissure; Lateral sphincterotomy; Outcome The treatment of chronic anal fissure is conservative and surgical [3]. The options are anal dilatation, carbon dioxide laser surgery,

Comparison Between Lateral Internal Anal Sphincterotomy and

To compare lateral internal anal sphincterotomy with 2% diltiazem in the treatment of chronic anal fissure in terms of fissure healing and complications. In group A six patients had healing of fissure after 4 weeks and a further 4 at 6 th week.

Dr. Sudhir Shinde M.S. Gen. Surgery, Department of Surgery

total of six months. Visual analogue scoring was used to assess pain. Lateral sphincterotomy was performed on patients not responding to conservative management. Result:A total of 190 patients conservatively managed of which 11 had recurrence of symptoms. Ten patients needed surgery.