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Thursday, December 5, 2013
Fissurectomy vs Sphincterotomy?
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?
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.
Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati