Anal Sphincterotomy Using the Notarás Technique in Patients Diagnosed with Anal Fissure
Keywords:
chronic anal fissure; sphincterotomy; Notarás surgical techniqueAbstract
Introduction: The Notarás surgical technique is a minimally invasive closed internal lateral sphincterotomy and is recommended for patients diagnosed with chronic anal fissure.
Objective: To present our experience with the Notarás procedure in patients diagnosed with anal fissures.
Methods: A descriptive, observational study was conducted on 11 patients diagnosed with chronic anal fissures who underwent the Notarás procedure as an outpatient major surgery under local infiltration anesthesia. Patients were selected according to inclusion and exclusion criteria and after obtaining informed consent, at the Coloproctology Department of the Comandante Manuel Fajardo University Clinical Surgical Hospital, from January 2024 to December 2025. The variables evaluated were sex, age, main symptoms, location of the fissure, postoperative complications, and treatment evaluation. Theoretical, clinical-surgical, and empirical methods were used.
Results: The 40–49 age group was the most common, as were female patients; among the symptoms, pain was the most prevalent, followed by mild rectal bleeding in the posterior region. Ninety percent of the patients were cured.
Conclusions: The Notarás procedure is a simple, outpatient surgical procedure with few adverse reactions; therefore, its use is recommended for patients with anal fissures.
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1. Narváez LEJ, Bravo PJA, Carrasco BMB, Pérez MPJ, Mendoza ACA, Morales SAM, et al. Fisiopatología, diagnóstico y manejo de las principales enfermedades anorrectales. Arch Ven Farmacol Terapeut. 2018 [acceso 02/12/2025];37(3):241-52. Disponible en: https://saber.ucv.ve/ojs/index.php/rev_aavft/article/download/15632/144814482297
2. Consenso Nacional de Fisura Anal, 2011. La Habana, Cuba. Sociedad Cubana de Coloproctología; 2011. [acceso 20/01/2025] Disponible en:
http://files.sld.cu/coloproctologia/files/2011/05/consenso-nacional-fisura-anal-2011-_2_.pdf
3. Madalinski MH. Identifing the best therapyfor anal fissure.World J Gastrointest Pharmacol Ther. 2011;2(2):6-9. DOI: https://doi.org/10.4292/wjgpt.v2.i2.9
4. Gordon PH. Fissure-in-ano. In: Gordon PH, Nivatvongs S. eds. Principles and practice of surgery for the colon, rectum and anus. 3rd ed. New York. NY: Informa Healthcare, USA, Inc; 2007 [acceso 20/01/2025]. p.167-89. Disponible en: https://archive.org/details/principlespracti0000gord
5. Cervantes PD, Rojas PY, Rodríguez GD, Álvarez CY, Torres BY, Gaspar SJ. La esfinterotomía lateral interna subcutánea cerrada en pacientes con fisura anal crónica. Arch méd Camagüey. 2020 [acceso 02/12/2025];24(1). Disponible en: https://revistaamc.sld.cu/index.php/amc/article
6. Garcia J, Belmonte C, Wong WD, Lowry AC, Madoff RD. Open vs. closed sphincterotomy for chronic anal fissure: long-term results. Dis Colon Rectum. 1996;39:440-43. DOI: http://dx.doi.org/10.1007/BF02054061
7. Barrios I, Anido V, Morera M. Declaración de Helsinki: cambios y exégesis. Rev Cub S Pública. 2016 [acceso 23/05/2024];42(1):0. Disponible en: http://scielosld.cu/scielo.php?script=sciarttext&pid=S0864-34662016000100014lng=es
8. Arroyo A, Pérez-Vicente F, Serrano P, Candela F, Sánchez A, Pérez-Vázquez MT, et al. Tratamiento de la fisura anal crónica. Cir Esp. 2005 [acceso 31/01/2026];78(2):68-74. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-tratamiento-fisura-anal-cronica-13077503
9. Feria SMK. Efectividad de la esfinterotomía anal en los pacientes atendidos en el servicio de coloproctología del Hospital “Vladimir Ilich Lenin”. REEA. 2020 [acceso 31/01/2026];5(2):442-67. Disponible en: http://www.eumed.net/rev/reea
10. Kutluk F, Ergün S, Mihmanli İ, Demiryas S, Hamid R, Perek A. The Effect of Sphincter Pressure and Anal Length on Surgical Decision in Chronic Anal Fissure. J Clin Med. 2025;14(11):3805. DOI: https://doi.org/10.3390/jcm14113805
11. Tanveer A, Arshad S, Fakih N, Farooq DA, Afyouni A, Kamran A, et al. Close lateral internal sphincterotomy versus open lateral internal sphincterotomy for chronic anal fissure: a systematic review and meta-analysis. Ann Med Surg (Lond). 2023;86(2):975-85. DOI: https://doi.org/10.1097/MS9.0000000000001593
12. Buendía TJP. Incontinencia en Operación de Fisura Anal. Clínica Proctológica. Tomás José Paco Buendía; 2021 [acceso 31/01/2026]. Disponible en: https://clinicaproctologica.com/incontinencia-en-operacion-de-fisura-anal
13. Kent I, Gilshtein H, Wexner SD. Fisura anal: anatomía, patogenia y tratamiento. R. arg. cir. 2020;112(4):388-97. DOI: https://doi.org/10.25132/raac.v112.n4.anwex
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