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Clinical, functional and morphologic evaluation of patients undergoing lateral sphincterotomy for chronic anal fissure treatment. Identification of factors that can interfere with fecal continence

Avaliação clínica, funcional e morfológica de pacientes submetidas à esfincterotomia para tratamento da fissura anal. Identificação dos fatores que podem interferir na continência fecal

Graziela Olivia da Silva Fernandes Sthela Maria Murad-Regadas Francisco Sérgio Pinheiro Regadas Lusmar Veras Rodrigues Iris Daiana Dealcanfreitas Jacyara de Jesus Rosa Pereira Erico de Carvalho Holanda Francisco Sérgio Pinheiro Regadas FilhoAbout the authors


Evaluate clinical, functional and morphologic outcomes of lateral sphincterotomy for chronic anal fissure treatment, and correlate the findings with factors that influence in the anal continence.


In a prospective study, female patients treated by lateral sphincterotomy for chronic anal fissure were assessed using Wexner's incontinence score and grouped according to score: group I (score = 0) and group 2 (score ≥1) and evaluated with anal manometry and anorectal 3D ultrasonography.


Thirty-six womens were included, 33% had vaginal delivery. Seventeen patients were included in group I and 19 in group II. We found no difference in age, parity and mode of delivery between groups. A significant difference with respect to percentage reduction in resting pressures was noted, when comparing group 1 versus group 2. The anal sphincter muscle length was similar in both groups. However, the length and percentage of transected internal anal sphincter was significantly greater in group II.


There was a correlation between fecal incontinence symptoms after sphincterotomy with the percentage of resting pressure reduction, length and percentage of transected internal anal sphincter.

Chronic anal fissure; Lateral internal sphincterotomy; Anorectal manometry; Anorectal three-dimensional ultrasound

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