Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 20;14(10):e30530.
doi: 10.7759/cureus.30530. eCollection 2022 Oct.

Lateral Internal Anal Sphincterotomy of Chronic Anal Fissure: An Experience of 165 Cases

Amer F Al-Ubaide  1 , Sami M Al-Rubaye  2 , Raid M Al-Ani  3
Affiliations

Lateral Internal Anal Sphincterotomy of Chronic Anal Fissure: An Experience of 165 Cases

Amer F Al-Ubaide et al. Cureus. .

Abstract

Background: The anal fissure is frequently seen in surgical practice. It is caused by a longitudinal tear in the anoderm distal to the dentate line. The hallmark feature of the disease is severe pain during defecation. Chronic anal fissure (CAF) causes undue stress that leads to poor quality of life. Different options of treatment, whether medical or surgical, are employed to treat this condition. One of these modalities is lateral internal anal sphincterotomy (LIAS).

Objectives: We aimed to assess the safety and efficacy of the LIAS surgical procedure for the treatment of CAF.

Materials and methods: This retrospective study was conducted at the Al-Muqdadiya General Hospital, Diala, Iraq, for a period from January 2016 to March 2021. The medical records of the patients with CAF who were subjected to LIAS under local anesthesia were reviewed. Data regarding the age, gender, smoking habit, body mass index (BMI), healing time, complications, and outcome for each participant were recorded.

Results: Of 165 participants, there were 91 men. The majority of the cases were ≤ 35 years (78.19%), were non-smokers (80%), and had no history of DM (98.79%). There was complete healing with a resolution of the pain at two months postoperatively in 163 subjects. The most common complication in our study was flatus incontinence (n = 5). All of them were found in the age group > 35 years and women. There were statistically significant differences between the age groups, gender, BMI, and the occurrence of flatus incontinence (P-value = 0.000, 0.012, and 0.009 respectively). However, there was no such association between smoking habit and a history of DM (P-value > 0.05). Conclusion: LIAS is safe and effective in the treatment of CAF, with an excellent outcome in resolving pain and a low complication rate. Age, female gender, and high BMI might affect the occurrence of flatus incontinence.

Keywords: anal fissure; chronic anal fissure; fecal incontinence; flatus incontinence; lateral internal anal sphincterotomy.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The distribution of the 165 patients regarding age and gender. P-value = 0.026.
Figure 2
Figure 2. The distribution of the 165 patients according to their smoking habits.
Figure 3
Figure 3. The distribution of the 165 patients according to the history of diabetes mellitus.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Anal fissure - an extensive update. Salati SA. Pol Przegl Chir. 2021;93:46–56. - PubMed
    1. Long-term results of lateral internal sphincterotomy for chronic anal fissure with particular reference to incidence of fecal incontinence. Nyam DC, Pemberton JH. Dis Colon Rectum. 1999;42:1306–1310. - PubMed
    1. Chronic anal fissure in adults. Gilani A, Tierney G. BMJ. 2022;376:0. - PubMed
    1. Surgical treatment of chronic anal fissure. A retrospective study of 1753 cases. Hsu TC, MacKeigan JM. Dis Colon Rectum. 1984;27:475–478. - PubMed
    1. Innovations in chronic anal fissure treatment: a systematic review. Poh A, Tan KY, Seow-Choen F. World J Gastrointest Surg. 2010;2:231–241. - PMC - PubMed

LinkOut - more resources