Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure

Posterolateral Versus Lateral Internal Anal Sphincterotomy for Chronic Anal Fissure: A Randomized Clinical Trial

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT03426449

Enrollment

Registered

2018-02-08

Start date

2015-01-01

Completion date

2018-01-01

Last updated

2018-02-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Anal Fissure

Brief summary

Detailed description

The present study aimed to compare the standard lateral internal sphincterotomy at 3 o'clock with posterolateral internal sphincterotomy at 5 o'clock in regards healing time, postoperative recurrence and complications, particularly fecal incontinence. We hypothesized that performing internal sphincterotomy in a point midway between the standard lateral position and the posterior midline position would confer better healing and relief of symptoms with less incidence of fecal incontinence while avoiding the development of keyhole deformity.

Interventions

PROCEDUREposterolateral sphincterotomy

Fissurectomy and limited division of internal anal sphincter at 5 o'clock position for 8-10 mm

PROCEDURElateral sphincterotomy

Fissurectomy and limited division of internal anal sphincter at 3 o'clock position for 8-10 mm

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Subject, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

16 Years to 65 Years

Healthy volunteers

Inclusion criteria

* Adult patients of both genders with chronic posterior anal fissure were included to the study.

Exclusion criteria

* Patients with anterior or lateral anal fissure, * patients with previous anal surgery, * patients with concomitant anorectal pathology, * patients with secondary anal fissure due to Crohn's disease or other specific etiology, * patients with any degree of fecal incontinence, * patients with active anorectal sepsis.

Design outcomes

Primary

Measure	Time frame	Description
Duration of healing	6-8 weeks after surgery	The time to complete healing of anal wound defined by complete epithelization of the wound

Secondary

Measure	Time frame	Description
Anal pain	1-6 weeks after surgery	Degree of postoperative pain assessed by pain visual analogue scale ranging from 0-10 where 0 indicates no pain and 10 indicates the worst possible pain

Countries

Egypt

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Mar 6, 2026