Postoperative Complications of Closed Lateral Sphincterotomy in Patients with Chronic Anal Fissure

Background: A chronic fissure of the anal canal is a painful condition of the anal canal that causes discomfort both during and after the defecation process. If the condition does not respond to medical treatment, closed lateral sphincterotomy is normally used. However, this procedure is associated with the risk of developing different postoperative complications. Objective: To determine the frequency of postoperative complications after closed lateral sphincterotomy in patients with chronic anal fissure. Study Design: Descriptive cross sectional study. Duration and Place of Study: This study was conducted from July 2024 to January 2025 in the Department of General Surgery, Lady Reading Hospital, Peshawar. Methodology: A total of 122 patients aged 18 to 70 years with chronic anal fissure were included. All patients underwent closed lateral sphincterotomy under regional anesthesia. Postoperative complications including pain, gas incontinence and fecal incontinence were assessed after surgery and during follow up. Data was analyzed using Statistical Package for Social Sciences version 26. Chi square test and Fisher exact test were applied, and p value less than 0.05 was considered significant. Results: The mean age of patients was 39.49 years. Postoperative pain was observed in 34.40% patients, gas incontinence in 9.00% and fecal incontinence in 5.70%. Age showed significant association with gas incontinence and fecal incontinence. Conclusion: Closed lateral sphincterotomy is an effective treatment for chronic anal fissure but postoperative complications are common especially pain and incontinence particularly in older patients.