{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:14:51Z","timestamp":1793639691608,"version":"4.5.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004913","name":"Universit\u00e0 degli Studi di Palermo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004913","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The standard treatment for chronic anal fissures that have failed non-operative management is lateral internal sphincterotomy. Surgery can cause de novo incontinence. Fissurectomy has been proposed as a sphincter\/saving procedure, especially in the presence of a deep posterior pouch with or without a crypt infection. This study investigated whether fissurectomy offers a benefit in terms of de novo post-operative incontinence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients surgically managed with fissurectomy or lateral internal sphincterotomy for chronic anal fissures from 2013 to 2019 have been included. Healing rate, changes in continence and patient satisfaction were investigated at long-term follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred twenty patients (55 females, 65 males) were analysed: 29 patients underwent fissurectomy and 91 lateral internal sphincterotomy. Mean follow-up was 55\u00a0months [confidence interval (CI) 5\u2013116\u00a0months]. Both techniques showed some rate of de novo post-operative incontinence (&gt;\u2009+3 Vaizey score points): 8.9% lateral internal sphincterotomy, 17.8% fissurectomy (<jats:italic>p<\/jats:italic>\u2009=\u20090.338). The mean Vaizey score in these patients was 10.37 [standard deviation (sd) 6.3] after lateral internal sphincterotomy (LIS) and 5.4 (sd 2.3) after fissurectomy Healing rate was 97.8% in the lateral internal sphincterotomy group and 75.8% in the fissurectomy group (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). In the lateral internal sphincterotomy group, patients with de novo post-op incontinence showed a statistically significant lower satisfaction rate (9.2\u2009\u00b1\u20091.57 versus 6.13\u2009\u00b1\u20093; <jats:italic>p<\/jats:italic>\u2009=\u20090.023) while no differences were present in the fissurectomy group (8.87\u2009\u00b1\u20091.69 versus 7.4\u2009\u00b1\u20091.14; <jats:italic>p<\/jats:italic>\u2009=\u20090.077).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Lateral internal sphincterotomy is confirmed as the preferred technique in term of healing rate. Fissurectomy did not offer a lower rate of de novo post-operative incontinence, but resulted in lower Vaizey scores in patients in whom this occurred. Satisfaction was lower in patients suffering a de novo post-operative incontinence after lateral internal sphincterotomy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10151-023-02780-8","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:32:12Z","timestamp":1679877132000},"page":"885-889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissures: no advantages in terms of post-operative incontinence"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-4689","authenticated-orcid":false,"given":"Roberta","family":"Tutino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casimiro","family":"Nigro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Paternostro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Federico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Lo Secco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Gallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Santarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Cocorullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Bonventre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"issue":"10","key":"2780_CR1","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1007\/s10350-007-9022-5","volume":"50","author":"AE Pelta","year":"2007","unstructured":"Pelta AE, Davis KG, Armstrong DN (2007) Subcutaneous fissurotomy: a novel procedure for chronic fissure in ano. A review of 109 cases. Dis Colon Rectum 50(10):1662\u20131667. https:\/\/doi.org\/10.1007\/s10350-007-9022-5","journal-title":"Dis Colon Rectum"},{"issue":"2","key":"2780_CR2","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1016\/j.jviscsurg.2014.07.007","volume":"152","author":"T Higuero","year":"2015","unstructured":"Higuero T (2015) Update on the management of anal fissure. J Visc Surg 152(2):S37-43. https:\/\/doi.org\/10.1016\/j.jviscsurg.2014.07.007","journal-title":"J Visc Surg"},{"issue":"11","key":"2780_CR3","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1007\/s11605-007-0255-3","volume":"11","author":"P Sileri","year":"2007","unstructured":"Sileri P, Mele A, Stolfi VM, Grande M, Sica G, Gentileschi P, Di Carlo S, Gaspari AL (2007) Medical and surgical treatment of chronic anal fissure: a prospective study. J Gastrointest Surg 11(11):1541\u20131548. https:\/\/doi.org\/10.1007\/s11605-007-0255-3","journal-title":"J Gastrointest Surg"},{"issue":"1","key":"2780_CR4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/DCR.0000000000000735","volume":"60","author":"DB Stewart Sr","year":"2017","unstructured":"Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR (2017) Clinical practice guideline for the management of anal fissures. Dis Colon Rectum 60(1):7\u201314. https:\/\/doi.org\/10.1097\/DCR.0000000000000735","journal-title":"Dis Colon Rectum"},{"issue":"6","key":"2780_CR5","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s00535-017-1335-0","volume":"52","author":"SM Ebinger","year":"2017","unstructured":"Ebinger SM, Hardt J, Warschkow R, Schmied BM, Herold A, Post S, Marti L (2017) Operative and medical treatment of chronic anal fissures-a review and network meta-analysis of randomized controlled trials. J Gastroenterol 52(6):663\u2013676. https:\/\/doi.org\/10.1007\/s00535-017-1335-0","journal-title":"J Gastroenterol"},{"issue":"5","key":"2780_CR6","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1080\/00015458.2003.11679478","volume":"103","author":"B Aytac","year":"2003","unstructured":"Aytac B, Cakar S (2003) Anal canal pressure in anal fissure before and after internal sphincterotomy. Acta Chir Belg 103(5):511\u2013512. https:\/\/doi.org\/10.1080\/00015458.2003.11679478","journal-title":"Acta Chir Belg"},{"key":"2780_CR7","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.19193\/0393-6384_2020_2_159","volume":"36","author":"R Tutino","year":"2020","unstructured":"Tutino R, Di Dio F, Kamdem LJ, Luddeni S, Iadicola D, Gulotta G, Cocorullo G (2020) Tailored treatments in internal rectal prolapse. Acta Medica 36:1007. https:\/\/doi.org\/10.19193\/0393-6384_2020_2_159","journal-title":"Acta Medica"},{"issue":"3","key":"2780_CR8","first-page":"182","volume":"40","author":"N Falco","year":"2019","unstructured":"Falco N, Tutino R, Fontana T, Gullo R, Licari L, Raspanti C, Cocorullo G (2019) Outpatient management of proctologic disease. Which techniques for local anesthesia? The experience of a single center. G Chir 40(3):182\u2013187","journal-title":"G Chir"},{"issue":"1","key":"2780_CR9","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1136\/gut.44.1.77","volume":"44","author":"CJ Vaizey","year":"1999","unstructured":"Vaizey CJ, Carapeti E, Cahill JA, Kamm MA (1999) Prospective comparison of faecal incontinence grading systems. Gut 44(1):77\u201380. https:\/\/doi.org\/10.1136\/gut.44.1.77","journal-title":"Gut"},{"issue":"3","key":"2780_CR10","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s00192-012-1886-9","volume":"24","author":"EMJ Bols","year":"2013","unstructured":"Bols EMJ, Hendriks HJM, Berghmans LCM, Baeten CGMI, De Bie RA (2013) Responsiveness and interpretability of incontinence severity scores and FIQL in patients with fecal incontinence: a secondary analysis from a randomized controlled trial. Int Urogynecol J 24(3):469\u2013478. https:\/\/doi.org\/10.1007\/s00192-012-1886-9","journal-title":"Int Urogynecol J"},{"issue":"4","key":"2780_CR11","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s11605-009-0908-5","volume":"2","author":"FF Ammari","year":"2004","unstructured":"Ammari FF, Bani-Hani KE (2004) Faecal incontinence in patients with anal fissure: a consequence of internal sphincterotomy or a feature of the condition? Surgeon 2(4):225\u2013229. https:\/\/doi.org\/10.1007\/s11605-009-0908-5","journal-title":"Surgeon"},{"issue":"7","key":"2780_CR12","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1007\/s10350-008-9273-9","volume":"51","author":"F Aigner","year":"2008","unstructured":"Aigner F, Conrad F (2008) Fissurectomy for treatment of chronic anal fissures. Dis Colon Rectum 51(7):1163\u20131163. https:\/\/doi.org\/10.1007\/s10350-008-9273-9","journal-title":"Dis Colon Rectum"},{"issue":"2","key":"2780_CR13","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3393\/ac.2017.06.12","volume":"34","author":"JD Zeitoun","year":"2018","unstructured":"Zeitoun JD, Blanchard P, Fathallah N, Benfredj P, Lemarchand N, de Parades V (2018) Long-term outcome of a fissurectomy: a prospective single-arm study of 50 operations out of 349 initial patients. Ann Coloproctol 34(2):83\u201387. https:\/\/doi.org\/10.3393\/ac.2017.06.12","journal-title":"Ann Coloproctol"},{"issue":"8","key":"2780_CR14","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1111\/j.1463-1318.2011.02840.x","volume":"14","author":"IL Schornagel","year":"2012","unstructured":"Schornagel IL, Witvliet M, Engel AF (2012) Five-year results of fissurectomy for chronic anal fissure: low recurrence rate and minimal effect on continence. Colorectal Dis 14(8):997\u20131000. https:\/\/doi.org\/10.1111\/j.1463-1318.2011.02840.x","journal-title":"Colorectal Dis"},{"issue":"12","key":"2780_CR15","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1007\/s00384-011-1284-7","volume":"26","author":"A Levin","year":"2011","unstructured":"Levin A, Cohen MJ, Mindrul V, Lysy J (2011) Delayed fecal incontinence following surgery for anal fissure. Int J Colorectal Dis 26(12):1595\u20131599. https:\/\/doi.org\/10.1007\/s00384-011-1284-7","journal-title":"Int J Colorectal Dis"},{"issue":"7","key":"2780_CR16","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1007\/s11605-009-0908-5","volume":"13","author":"SR Mousavi","year":"2009","unstructured":"Mousavi SR, Sharifi M, Mehdikhah ZA (2009) Comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure. J Gastrointest Surg 13(7):1279\u20131282","journal-title":"J Gastrointest Surg"},{"issue":"2","key":"2780_CR17","first-page":"607","volume":"12","author":"MMT Saeed","year":"2018","unstructured":"Saeed MMT, Khan SSA, Ali Z, Mumtaz R (2018) A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure. PJMHS 12(2):607\u2013610","journal-title":"PJMHS"}],"container-title":["Techniques in Coloproctology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-023-02780-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10151-023-02780-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10151-023-02780-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T16:05:36Z","timestamp":1694102736000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10151-023-02780-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,16]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["2780"],"URL":"https:\/\/doi.org\/10.1007\/s10151-023-02780-8","relation":{},"ISSN":["1123-6337","1128-045X"],"issn-type":[{"value":"1123-6337","type":"print"},{"value":"1128-045X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,16]]},"assertion":[{"value":"16 November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research study was conducted retrospectively from data obtained for clinical purposes and did not need ethical approval. The study was conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}