Comparative Short-Term Results of Open versus Closed Techniques: An Approach towards Internal Lateral Sphincterotomy in Yaoundé | Chapter 17 | New Horizons in Medicine and Medical Research Vol. 9

 The goal of this research was to compare the short- and medium-term outcomes of open and closed internal lateral sphincterotomies.

Over a 15-month period, we conducted a prospective randomised comparative research in the Central Hospital of Yaounde's digestive and visceral surgery departments. Patients were evaluated for each technique based on a variety of criteria, including operation length, post-operative pain, recurrence, surgical site infection, gas and/or stool incontinence, and healing time, with a 12-month follow-up.

There were 63 patients in all who had surgery, including 32 open lateral internal sphincterotomies (group 1) and 31 closed lateral internal sphincterotomies (group 2). (group 2). With a sex ratio of 1.25, there were 35 men and 28 women. The posterior commissure was home to the bulk of fissures. The operation took an average of 15.34 minutes in patients in group 1 compared to 5.22 minutes in patients in group 2. We found 3.12 percent of surgical wound infections in group 1 patients, but none in group 2. 6.45 percent of group 2 patients and 28.12 percent of group 1 patients had gas incontinence. At 24 hours after surgery, the mean degree of pain in groups 2 and 1 was between 4 and 6 on the visual analogue scale, and between 7 and 10 in group 1. Wound healing took 8.9 days for group I and 4 days for group 2. Both patients stayed in the hospital for 24 hours. There was no recurrence over the 6-month follow-up period.

Closed lateral internal anal sphincterotomy is the treatment of choice for chronic anal fissures because it is effective and has a lower complication rate than open sphincterotomy.

Author(S) Details

Georges Bwelle Motto
Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Cameroon and Department of Visceral and Digestive Surgery, Yaounde Central Hospital, Cameroon.

Yannick Mahamat Ekani Boukar
Department of Surgery, University of Buea, Cameroon.

Guy Aristide Bang
Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Cameroon.

Joseph Cyrille Chopkeng Ngoumfe
Department of Visceral and Digestive Surgery, Yaounde Central Hospital, Cameroon.

Fabrice Tientcheu Tim
Department of Visceral and Digestive Surgery, Yaounde Central Hospital, Cameroon.

Arthur Essomba
Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Cameroon and  Department of Visceral and Digestive Surgery, Yaounde Central Hospital, Cameroon.

Maurice Aurelien Sosso
Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Cameroon.

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