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International Journal of Colorectal Disease

Published in:

01-10-2009 | Original Article

Subcutaneous lateral internal sphincterotomy (SLIS)—a safe technique for treatment of chronic anal fissure

Authors: Jim S. Khan, Neil Tan, Dariush Nikkhah, Andrew J. G. Miles

Published in: International Journal of Colorectal Disease | Issue 10/2009

Abstract

Objective

Subcutaneous lateral internal sphincterotomy (SLIS) is an effective treatment for fissure in ano but carries a definite risk of incontinence. The aim of this study was to assess the efficacy and complications of SLIS in patients with chronic fissure in ano.

Materials and methods

All patients presenting with a chronic anal fissure who underwent SLIS were entered into a prospective database. This is a review of these patients over 5 year’s period (September 2002–2007). All operations were performed or directly supervised by a consultant colorectal surgeon. Short-term follow-up was at the first outpatient appointment (6 weeks postoperatively) and any impairment of continence was documented.

Results

During the study period of 5 years, 96 patients underwent SLIS at our institution. Median patient age was 45 years (range 19–81). The median duration of symptoms was 65 days. No fissure failed to heal after SLIS. Minor complications were noted in five patients; 85% (82/96) attended the follow-up and out of these, 6% (5/82) reported early incontinence. One patient was incontinent to flatus, one to liquid and three to solid stool. After 12 weeks of follow-up, two patients were completely symptom free, one was incontinent to flatus and two were incontinent to liquid stool.

Conclusion

SLIS remains an effective treatment for chronic anal fissure. A small proportion of patients do suffer from faecal incontinence, which may be permanent in some cases. Careful patient selection and proper surgical training can reduce this risk.

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Title: Subcutaneous lateral internal sphincterotomy (SLIS)—a safe technique for treatment of chronic anal fissure
Authors: Jim S. Khan
Neil Tan
Dariush Nikkhah
Andrew J. G. Miles
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 10/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-009-0765-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Subcutaneous lateral internal sphincterotomy (SLIS)—a safe technique for treatment of chronic anal fissure

Abstract

Objective

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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