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Comparison of Lateral Internal Sphincterotomy Techniques for Chronic Anal Fissure
Sponsor: Çanakkale Onsekiz Mart University
Summary
This prospective randomized controlled trial compares three lateral internal sphincterotomy (LIS) techniques in patients with chronic anal fissure refractory to medical treatment: (1) Spasm-Controlled LIS (serial small sphincterotomies using an anal calibrator until 30 mm anal caliber is achieved, under local anesthesia plus sedation), (2) LIS up to the Fissure Apex (spinal or general anesthesia), and (3) LIS up to the Dentate Line (spinal or general anesthesia). The primary outcomes are fissure healing rate and fecal incontinence incidence at 12 months, assessed using the Wexner Incontinence Score. Secondary outcomes include postoperative pain (VAS), recurrence rate, patient satisfaction, and complications. A total of 150 patients (50 per group) will be enrolled and followed for 12 months.
Official title: A Prospective Randomized Controlled Trial Comparing Spasm-Controlled, Fissure Apex-Limited, and Dentate Line-Limited Lateral Internal Sphincterotomy Techniques in Chronic Anal Fissure
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
150
Start Date
2026-05-01
Completion Date
2028-05-01
Last Updated
2026-04-09
Healthy Volunteers
No
Conditions
Interventions
Spasm-Controlled Lateral Internal Sphincterotomy
Serial small open sphincterotomies under local anesthesia plus IV sedation using an anal calibrator until anal caliber of 30 mm is achieved.
Lateral Internal Sphincterotomy up to Fissure Apex
Open LIS extended to the proximal end of the fissure under spinal or general anesthesia.
Lateral Internal Sphincterotomy up to Dentate Line
Open LIS extended to the level of the dentate line under spinal or general anesthesia.
Locations (1)
Canakkale Onsekiz Mart University
Çanakkale, Çanakkale, Turkey (Türkiye)