Outcomes of Fissurectomy and Advancement Flap in Management of Chronic Anal Fissure


  • Khairallah Muzhir Gabash
  • Saleh Omairi
  • SarabMuhammed Zeki RAdhi




Fissurectomy, Chronic,Anal canal, Fissure, Tissue and Flap


Chronic anal fissure is a painful linear tear in the mucocutaneous junction of the distal part of the anal
canal and involves the full thickness of mucosa, causing severe pain may last even hours after defecation.
Usually,it occurs along the midline either anterior or posterior,if it presents off the midline, other pathology
might be associated with. Unhealed anal fissure after 6-8 weeks is defined chronic, with the presence of other
criteria,it unlikely heals with medical treatment, and surgery is mandatory after pharmacological treatment
failure. Lateral internal sphincterotomy had high healing rate, but unfortunately, with risk of incontinence.
Fissurectomywithcomplete excision of the fissure keeping the internal anal sphincter intact,and an
advancement flap of well vascularized tissue is transferred to cover the base of fissure and improve healing.
This study mainly aiming to analyze the outcome of fissurectomy with advancement flap procedure in the
treatment of chronic anal fissure and highlight its advantage in terms of healing rate and complications
especially anal incontinence.During a period of about 5 years 345 patients (260 males and 85 females), have
been included in this study and were diagnosed as cases of chronic anal fissure. After administration of local
anesthetic,fissurectomywith advanced flap was performed. Patients had been followed up regularly for 6-24
months. Data collected and statistical analysesby using SPSS. About 75% of
patients were males while, 25% were females, their ages were between 20-59 year, most of the patients were
in thirties, nevertheless most of the females were in twenties.Mean time for wound healing was 10 days.
Whilst complete fissure healing process lasting approximately one month. About 11.9% of the patients take
more than one month to complete healing process. Healing rate was 100% after the follow up period of 6-24
months. Recurrence developed only in 2% of the patients. None of the patients developed incontinence,
anal stenosis, key hole deformity, necrosis or urine retention. From this study concluded Fissurectomy with
advancement flap in the treatment of chronic anal fissure is cost effective procedure, can be done under LA
with least time-off work, with low complication, low recurrence,and no incontinence.

Author Biographies

Khairallah Muzhir Gabash

 Assist. Prof. Department of Surgery / College of Medicine / Wasit University

Saleh Omairi

Lect., Department of Anatomy and Biology / College of Medicine / Wasit University,

SarabMuhammed Zeki RAdhi

B.D.S.MSc Oral and Maxillofacial Radiology Wasit health Directorate




How to Cite

Khairallah Muzhir Gabash, Saleh Omairi, & SarabMuhammed Zeki RAdhi. (2021). Outcomes of Fissurectomy and Advancement Flap in Management of Chronic Anal Fissure. Indian Journal of Forensic Medicine & Toxicology, 15(4), 1574–1579. https://doi.org/10.37506/ijfmt.v15i4.16932