Complications and results of lateral internal sphincterotomy for chronic anal fissure

Background Treatment of chronic anal fissure has been directed at relaxing increased sphincter tone. Lateral internal sphincterotomy (LIS), since its introduction in 1951 by Eisenhammer, has been considered the gold standard approach with healing rate of approaching 95%. However, concerns have been raised about postoperative impairment of faecal incontinence after LIS. Actually, the incidence of faecal incontinence reported in literature varies widely from 1.3% to 30% or more. Several factors have been associated to affect LIS outcomes and morbidities, first of all accurate surgical technique, length of sphincterotomy, previous anorectal surgery, additional procedures and obstetric history.