The Comparison of Outcomes and Postoperative Side Effects of Partial and Total Sphincterotomy in Patients With Anal Fissure

Background and Objectives: Anal fissure is a painful wound in the anoderm and distal to dentate line, the chronic fissure leads to hypertrophy and fibrosis. In this study, we compared partial and total sphincterotomy in patients with chronic anal fissure. Methods: In this comparative cohort, 100 patients (52 female and 48 male) mean age 43.34 ± 15.28 years with chronic anal fissure referred to the Shahid Mohammadi hospital, Bandar Abbas, Iran were randomly assigned into partial or total sphincterotomy groups (50 patients in each group). Then the postoperative complications including, pain, bleeding, incontinence to flatus or to flatus and soiling, infection and abscess, hematoma, anal stenosis and recurrence of anal fissure within one year after operation were compared between 2 groups. Findings: The flatus incontinence in total group was significantly more than partial, and the level of pain in total group was significantly lower than partial. The rate of recurrence and incontinence to flatus and soil in total group was non- significantly more than the partial group. On the other hand, bleeding and hematoma, infection, abscess and discharge in total group was lower than partial, but the difference was not significant. Satisfaction in the 2 groups was the same. Conclusions: Our study revealed the effectiveness of partial and total sphincterotomy techniques in patients with chronic anal fissure and showed the 2 approaches were associated with comparable outcomes, in terms of side effect, recurrence, and satisfaction. However, total sphincterotomy was related to lower pain and partial sphincterotomy with lower flatus incontinence.