Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure.

Abstract

This study was designed to assess differences between lateral internal anal sphincterotomy and anal advancement flap for chronic anal fissure. Forty patients with chronic anal fissure were prospectively studied. Patients randomized to the sphincterotomy group (n = 20; median age, 34 (range, 16-61) years) underwent lateral internal anal sphincterotomy. Patients randomized to the flap group (n = 20; median age, 32 (range, 20-44) years) had an anal advancement flap. All fissures in the sphincterotomy group healed following surgery compared with three patients that failed to heal in the flap group (P = 0.12). No patient in either group was incontinent to any degree following surgery. Patient satisfaction with surgery was similar in both groups. Anal advancement flap is an alternative to lateral sphincterotomy for chronic anal fissure.