Performing internal sphincterotomy with other anorectal procedures.

Purpose: A study was conducted to compare the outcome of combined anorectal procedures involving lateral internal sphincterotomy with lateral internal sphincterotomy alone to determine if the former results in increased complications.

Methods: Complications and anal function of 57 patients who underwent lateral internal sphincterotomy for chronic anal fissure in conjunction with another anorectal procedure (combined group) between April 1989 and June 1992 were compared with 57 other age- and sex-matched patients who underwent lateral internal sphincterotomy alone (control group).

Results: There was no statistical difference in the incidence of incontinence in the combined group (8.7 percent) and the control group (7 percent). None of the cases in either group had permanent incontinence. There were also no statistical differences in the incidence of postoperative bleeding, pruritus ani, mucus discharge, abscess formation, fistulation, and rates of fissure recurrence.

Conclusions: Additional anorectal procedures performed at the same time as internal sphincterotomy do not increase the incidence of postoperative complications.