Surgical Treatment of Anal Fissures: Population and Outcomes of an Ambulatory Surgical Center

Purpose: To characterize the population of patients undergoing surgical treatment of anal fissures; to assess the outcomes and complications of the procedures in an ambulatory surgical center; and to evaluate the satisfaction degree of the patients. Methods: Demographic data, type of procedure and complications of patients who underwent surgical treatment for anal fissuresin the Integrated Center for Ambulatory Surgery of Centro Hospitalar do Porto CICA-CHP) were reviewed. A questionnaire (created by the authors to assessthe satisfaction, the quality of life and restrictions after the surgery and to identify the main advantages for an outpatient care) and the Cleveland Clinic Incontinence Score and the Fecal Incontinence Quality of Life Instrument (FIQLI) were applied. Results: The study included 88 participants; the mean age was 47.2 years and 62.5% were female; 75% underwent lateral internal sphincterotomy (ELI) and 25% fissurectomy and V-Y. The global satisfaction was 9.6/10, the absence of hospitalization was considered an advantage(4.5/5), the mean period of inability for professional activitieswas 11.8 days; the pain was moderate (2.9/5) and the pain control with oral analgesics wasclassified in 4.5/5. In the FIQLI no one had concern about accidental bowel leakage nor felt sad in relation to its proctologic health. In the Cleveland Clinic Incontinence Scoreno patients referred incontinence. Conclusion: The treatment of anal fissure has been evolving and with this work we realize that anal fissure surgery can be safely performed on an outpatient basis respecting the dignity and comfort of the patient.