Comparison of Lateral Internal Sphincterotomy Techniques for Chronic Anal Fissure

This prospective randomized controlled trial compares three lateral internal sphincterotomy (LIS) techniques in patients with chronic anal fissure refractory to medical treatment: (1) Spasm-Controlled LIS (serial small sphincterotomies using an anal calibrator until 30 mm anal caliber is achieved, under local anesthesia plus sedation), (2) LIS up to the Fissure Apex (spinal or general anesthesia), and (3) LIS up to the Dentate Line (spinal or general anesthesia). The primary outcomes are fissure healing rate and fecal incontinence incidence at 12 months, assessed using the Wexner Incontinence Score. Secondary outcomes include postoperative pain (VAS), recurrence rate, patient satisfaction, and complications. A total of 150 patients (50 per group) will be enrolled and followed for 12 months.

NCT Number	NCT07520552
Lead Sponsor	Çanakkale Onsekiz Mart University
Conditions	Chronic Anal Fissure
Enrollment	150 participants
Start Date	2026-05-06
Primary Completion	2027-05-06 (estimated)
Study Completion	2028-05-06 (estimated)
Updated on ClinicalTrials.gov	2026-05-14