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Colorectal Diseases

Fissurectomy vs Sphincterotomy?

07/24/2008

Question:

I am 30 years old, female and in good health. I have had a fissure off and on for the past 4 years. I finally decided to get the lateral internal sphincterotomy done, however, I was looking into alternative surgical procedures and I came accross one that is called a Fissurectomy. Fissurectomy or fissure excision creates a fresh surgical wound that might then allow stable wound healing. Is this a good alternative to LIS and is it worth looking into?

Answer:

Fissurectomy is an alternative, but will not be as successful as division of the internal sphincter if what you have is a tight, fibrotic, hypertrophic internal sphincter from chronic fissure and the resultant spasm. Fissurectomy and closure covers the chronic wound, and is a reasonable procedure for those whose bowel problems have completely resolved and are at high risk for incontinence with sphincterotomy.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati