Comparison of Partial Internal Sphincterotomy and Partial Internal Sphincterotomy with Additional Advancement Flap Anoplasty in the Treatment of Chronic Anal Fissure

Introduction: We aimed to compare the results of our patients who have undergone lateral internal sphincterotomy and lateral internal sphincterotomy with additional advancement flap anoplasty. The success rate and complication rate of both methods were compared concerning the literature. Materials and methods: We have retrospectively evaluated charts of patients who have undergone the operation for chronic anal fissure between January 2015 and July 2018. A total of 123 patients were separated into two groups as partial Lis+anoplasty (group-I, n:76) and only partial Lis (group-II, n:47) groups. Age, sex, follow up time, anal examination findings, pain, bleeding, constipation score, patient satisfaction score, VAS pain score during rest or stooling, and recurrence and continence rates of patients were recorded. Results: 61 male (49,59%) and 62 female (50,41%) total 123 patients were included. The mean age of the patients was 42,87±11,69 years. The duration of the operation was 28,50±11,61 min. The hospital stay was 1,50±0,70 days. The mean follow-up time was 24±10 months. In group-II patients (15.22%), the recurrence was higher than group I. Similarly, bleeding (10.87%), pain (13.04%), and discomfort (15.22%) were higher in group-II compared to group-I. Bleeding, constipation score, VAS stooling and resting scores were higher in group-II, while the satisfaction score was found higher in group-I. There was no difference between the two groups in terms of incontinence rate. Conclusion: Adding advancement flap anoplasty to partial internal sphincterotomy has increased the success rate by decreasing recurrences in our study and similar studies in the literature.