Lateral Internal Sphincterotomy versus Botulinum Toxin as Treatment of Anal Fissure

Authors

Keywords:

anal fissure, internal lateral sphincterotomy, botulinum toxin

Abstract

Introduction: Chronic anal fissure is a frequent entity that produces discomfort during and after defecation. Its pathophysiology is not clear and its management is varied. Lateral internal sphincterotomy is one of the most used techniques, although its high percentage of incontinence is not accepted; botulinum toxin injection is therefore a tempting alternative.

Objective: To compare the results of botulinum toxin type A injection or lateral internal sphincterotomy for treatment of anal fissure in terms of postoperative pain, recurrence, healing and incontinence.

Methods: A cohort study was carried out. One group of 40 patients were treated with injection of 50 IU of botulinum toxin type A and another group of 42 patients underwent lateral internal sphincterotomy. The results were statistically compared with a confidence interval of 95% and error of 0.05.

Results: Sphincterotomy and botulinum toxin were effective in terms of healing in 85.4% and 77.5% of cases, respectively. Recurrences occurred in 4.8% and 12.5% of cases, respectively. Incontinence occurred in 9.5% and 2.5% of cases, respectively. Postoperative pain was present in 14.8% and 5.0% of cases, respectively.

Conclusions: Sphincterotomy was better in terms of healing and recurrence, while botulinum toxin application showed better results regarding fecal incontinence and postoperative pain.

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Author Biographies

Alfredo Lázaro Marín Pérez, Universidad Técnica de Manabí, Ecuador Ministerio de Salud Pública, Ecuador

Profesor Titular Principal Universidad Técnica de Manabí, Ecuador. Especialista de II Grado en Cirugía General.

Nancy Toledo Santana, Universidad Técnica de Manabí

Master en atención Integral al niño, Profesora Agregada Titular.

Franklyn Rogelio Cedeño Carreño, Ministerio de Salud Pública de Ecuador

Medico Cirujano, Universidad Técnica de Manabí, Ecuador.

Alymays Marín Hernández, Hospital Universitario Miguel Enriquez , La Habana

Medico General Integral, Especialista de I Grado en Cirugía Plástica, Profesora Auxiliar.

Juan Antonio Ramírez Fernández, Hospital del IESS, Manta , Zonal 4, Manabí

Especialista de I Grado en Anestesia y Reanimación.

Ilien Alnay Marín Toledo, Hospital IESS, Zonal 4, Universidad Técnica de Manabí.

Especialista de Anestesia y Reanimación, Profesora de la Universidad Técnica de Manabí

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Published

2022-03-03

How to Cite

1.
Marín Pérez AL, Toledo Santana N, Cedeño Carreño FR, Marín Hernández A, Ramírez Fernández JA, Marín Toledo IA. Lateral Internal Sphincterotomy versus Botulinum Toxin as Treatment of Anal Fissure. Rev. Cub. Cir. [Internet]. 2022 Mar. 3 [cited 2025 Jan. 29];61(1). Available from: https://revcirugia.sld.cu/index.php/cir/article/view/1190

Issue

Vol. 61 No. 1 (2022): Enero - Marzo

Section

Artículos originales

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