[Dilatation or sphincterotomy as the treatment of primary-chronic fissure in ano. Results of a random, clinical study after 2-3 years].

In a randomized clinical trial, 66 patients were treated for primary chronic fissure-in-ano by anal dilatation or sphincterotomy. Of the 64 patients still living, 57 (89.0%) could be submitted to a follow-up examination 26.7 +/- 4.6 months after the operation; 63 of them were surveyed on the basis of a questionnaire. Six patients who had reported functional lesions after operation at a six-month follow-up were reexamined: in two cases improvements were recorded, in the case of three patients the symptoms remained unchanged, and in one case a complete reduction was achieved. Though no significant difference (p less than 0.1) was noted with a recurrence rate of 20.5% (n = 7) after the dilatation versus 3.1% (n = 1) after the sphincterotomy, a definite trend was obvious. These findings support the sphincterotomy as being a definitive therapy for primary chronic fissure-in-ano.