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2243993 
Journal Article 
Total lateral sphincterotomy for anal fissure 
Tocchi, A; Mazzoni, G; Miccini, M; Cassini, D; Bettelli, E; Brozzetti, S 
2004 
Yes 
International Journal of Colorectal Disease
ISSN: 0179-1958
EISSN: 1432-1262 
19 
3 
245-249 
English 
13680282 
WOS:000220562000012 
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. 
anal fissure; total internal sphincterotomy; incontinence