ABSTRACT

Anal fissure is a modified mucosal tear in the anal canal. It is usually presented with rectal bleeding and pain. While most of the acute cases are treated with conservative methods, chronic anal fissures are needed surgical intervention. Lateral internal sphincterotomy is used for this purpose. We aimed to demonstrate the rates of anal incontinence after lateral internal sphincterotomy and risk factors related with it.

Between March 2009 and February 2010, 56 patients with the diagnosis of chronic anal fissure and 3 and 4. degree hemorrhoids operated with LIS were studied retrospectively. Data about patient’s age, sex, preoperative symptoms, operation details, postoperative complications were collected. The risk factors, age,sex, vaginal delivery and perianal surgery (hemorrhoidectomy) were also studied.The data was evaluated with SSPS 13 for Windows program.

A series of 56 patients who had been operated with diagnosis of chronic anal fissure or hemorrhoidal disease were studied. There were 19 men (%33.9) and 37 women (%66.1). The mean age was 32±8,095 (range-19-62). The preoperative diagnosis was chronic anal fissure in 41(%73.2) and hemorrhoid in 15(%26.8) patients. The mean operation time was 20 minutes (range 10-55 minutes). The all patients were dischared within 24 hours after surgery. There were 3(%5.4) transient gas incontinence and 5 (%8.9) persistant gas incontinence in this serial. The hemorrhoidectomy that has been performed with sphincterotomy was found a most important risk factor for development of incontinence. Older age and male sex was found minor risk factors.

Lateral internal sphincterotomi is one of the most commonly performed surgical operation. The anal incontinence is an important complication after surgery. Although fecal incontinence is rare, patients may experience transient or persistant gas incontinence with LIS. Hemorrhoidectomy performed with LIS is seems to be major risk factor that increase the incontinence rates in this serial.