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  • Title: Total lateral sphincterotomy for anal fissure.
    Author: Tocchi A, Mazzoni G, Miccini M, Cassini D, Bettelli E, Brozzetti S.
    Journal: Int J Colorectal Dis; 2004 May; 19(3):245-9. PubMed ID: 13680282.
    Abstract:
    BACKGROUND AND AIMS: Initial experience with the posterior sphincterotomy for treating anal fissures was unsatisfactory, with a significant rate of recurrences and anal incontinence. This report describes the lateral approach to complete section of the internal sphincter. PATIENTS AND METHODS: Between 1997 and 2001 we surgically treated 164 patients for anal fissure. Preoperative and postoperative anal manometries were recorded. Postoperative course and early and long-term results were recorded. RESULTS: No fissure failed to heal. Early complications included bleeding, hematoma, and pain. A transient, variable degree of incontinence occurred in 15 patients and persistent incontinence to flatus and soiling in 5. After total sphincterotomy no long-term complication was observed. Patient satisfaction was 96%. CONCLUSION: Total subcutaneous, internal sphincterotomy is a safe, effective procedure for the treatment of chronic anal fissure.
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