LATERAL INTERNAL SPHINCTEROTOMY FOR CHRONIC ANAL FISSURE: 10-YEARS' EXPERIENCE IN A SPECIALIST COLORECTAL UNIT.

PURPOSE: The aim of the study was to determinate the long-term outcome, recurrence rate and faecal incontinence after lateral internal sphincterotomy for chronic anal fissure (CAF) after failure of conservative treatment. METHODS:110 consecutive patients underwent surgery for a medically resistant CAF between 2002 and 2012. All data were prospectively collected and entered in a database including demographics, type of surgery, complications, healing time, incontinence (FISI score) and satisfaction with the operation (score 1-4). All patients were seen after surgery at 1 week, 1 month, six months and annualy threafter for 5 years. Patients were then contacted by phone. RESULTS: Median follow up was 3.5 years. 11 parients were lost at the follow-up. Overall complications rate was 5% ( 6 out of 110). Postoperative incontinence was 4.5% ( 5 out of 110). At the end of the follow.up 1 patient (1%) experienced significative incontnence (FISI score >5). Overall healing was achieved in 95% (94/99 patients), 91% of patients would have consented to the operation again if necessary. CONCLUSIONS: In our experience LIS remains the treatment ofchoice for medically resistant CAF, recurrence rate is low wiyh a minimal impact on continence.