Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure

Mansoura University

Status: Completed

Conditions: Anal Fissure

Treatments: Procedure: posterolateral sphincterotomy; Procedure: lateral sphincterotomy

Study type: Interventional

Funder types: Other

Identifiers

NCT03426449

mansourau45

Details and patient eligibility

About

The present study aimed to compare the standard lateral internal sphincterotomy at 3 o'clock with posterolateral internal sphincterotomy at 5 o'clock in regards healing time, postoperative recurrence and complications, particularly fecal incontinence.

Full description

The present study aimed to compare the standard lateral internal sphincterotomy at 3 o'clock with posterolateral internal sphincterotomy at 5 o'clock in regards healing time, postoperative recurrence and complications, particularly fecal incontinence. We hypothesized that performing internal sphincterotomy in a point midway between the standard lateral position and the posterior midline position would confer better healing and relief of symptoms with less incidence of fecal incontinence while avoiding the development of keyhole deformity.

Enrollment: 80 patients

Sex: All

Ages: 16 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients of both genders with chronic posterior anal fissure were included to the study.

Exclusion criteria

• Patients with anterior or lateral anal fissure,
• patients with previous anal surgery,
• patients with concomitant anorectal pathology,
• patients with secondary anal fissure due to Crohn's disease or other specific etiology,
• patients with any degree of fecal incontinence,
• patients with active anorectal sepsis.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

Posterolateral sphincterotomy

Active Comparator group

Description:

Division of internal anal sphincter at 5 o'clock position

Treatment:

Procedure: posterolateral sphincterotomy

Lateral sphincterotomy

Active Comparator group

Description:

Division of internal anal sphincter at 3 o'clock position

Treatment:

Procedure: lateral sphincterotomy