[Long-term results of excision of anal fissure in combination with lateral subcutaneous sphincterotomy].

One hundred and seventeen patients with anal fissure underwent fissure excision in combination with lateral subcutaneous sphincterotomy. The mean follow-up after treatment was 4.3 years. All the patients were questioned by the phone. Thirty-six ones who had some symptoms were examined at outpatient department. The examination included physical examination, anorectal manometry, endorectal ultrasonography, irrigoscopy, defecography. Recurrences of anal fissure were revealed in 12 (10.2%) patients. The cause of recurrence was incomplete sphincterotomy. Different grade of anal incontinence was revealed in 23 patients: 2 of them had soiling, 12 -- incontinence of the flatus, 8 -- incontinence of liquid faeces, 1 -- incontinence of solid faeces. In 4 patients the cause of anal incontinence was excessive sphincter section during sphincterotomy, in 16 -- perineal descent syndrome, in 3 -- advanced age. It is concluded that it is necessary to modify surgical technique and to examine patients more carefully before surgery including anorectal manometry.