Endoanal ultrasonographic assessment after lateral internal sphincterotomy for chronic anal fissure: protocol for a prospective longitudinal cohort study.

NCT ID NCT07809711

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First seen Sep 09, 2026 · Last updated Sep 09, 2026

Summary

Chronic anal fissure is a painful tear in the lining of the anal canal that may not heal with medication or other non-surgical treatments. Lateral internal sphincterotomy is a commonly used surgical treatment. However, the amount of internal anal sphincter muscle divided during surgery may affect both fissure healing and the risk of impaired bowel control. The purpose of this prospective observational study is to assess whether the extent of internal anal sphincter division, measured using three-dimensional endoanal ultrasound, is associated with fissure healing and changes in anal continence during the first year after surgery. The study will include 66 adults with chronic anal fissure undergoing open or closed lateral internal sphincterotomy as part of their usual clinical care. The surgical technique will be selected by the treating clinical team and will not be assigned by the researchers. Participants will be assessed before surgery and at 3, 6, and 12 months after surgery. At the 3-month visit, they will undergo two-dimensional and three-dimensional endoanal ultrasound. Two independent observers will separately review the stored ultrasound images. Follow-up assessments will evaluate fissure healing or recurrence, bowel control, faecal soiling, pain, bleeding, postoperative complications, and quality of life. The findings may help identify the extent of sphincter division that provides effective fissure healing while limiting the risk of postoperative anal incontinence.

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Study facts

What this study's own registry entry says, in plain language.

Participants

About 66 people

The number the study aims to enrol. It can still change while the study runs.

Started

Oct 2024

Expected to finish

May 2028

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Who is studied

Adults evaluated in the colorectal outpatient clinics of Hospital Clínico Universitario de Valencia with primary chronic anal fissure that has not responded to 6-8 weeks of conservative treatment and who are scheduled to undergo open or closed lateral internal sphincterotomy as part of routine clinical care. Consecutive potentially eligible patients will be assessed by a colorectal surgeon and invited to participate. Only participants who meet the eligibility criteria and provide written informed consent will be enrolled. Healthy volunteers will not be included.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 years or older. * Primary chronic anal fissure, defined as symptoms lasting more than 6-8 weeks and failure of complete conservative treatment, irrespective of the presence of anatomical signs of chronicity. * Clinical indication for open or closed LIS. * Capacity to understand the study, complete the questionnaires and provide written informed consent. Exclusion Criteria: * Acute anal fissure of less than 6-8 weeks' duration. * Secondary anal fissure associated with Crohn's disease, ulcerative colitis, tuberculosis, HIV infection, anal malignancy or another identified secondary cause. * Neurological or neuromuscular disease that may affect continence. * Moderate or severe anal incontinence at baseline. * Concomitant anorectal disease requiring another procedure, including symptomatic haemorrhoids or anal fistula. * Previous or current circumstances that prevent reliable completion of patient-reported measures. * Anticipated inability to attend postoperative follow-up. * Incomplete conservative treatment before the decision for surgery. * Participants may withdraw consent at any time without affecting their care. Investigators may discontinue study follow-up if eligibility was incorrectly assigned or if a clinical event prevents completion of study procedures. Data collected before withdrawal will be handled in accordance with the consent form and applicable legislation.

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Conditions

The condition(s) this trial relates to.

Encopresis Fissure in Ano

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

How to take part

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  1. The places running it

    1 site. The list below names each one and where it is.

  2. The official record

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  3. A doctor treating you

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Contacts and locations

Locations

  • Francisco Castillejos-Ibáñez

    RECRUITING

    Valencia, 46010, Spain

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