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

PURPOSE: This study was designed to assess differences between lateral internal anal sphincterotomy and anal advancement flap for chronic anal fissure.

METHODS

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.

RESULTS

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.

CONCLUSION

Anal advancement flap is an alternative to lateral sphincterotomy for chronic anal fissure.