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Corresponding author: Beshoy Tharwat Eskander Zakaria ., tharwat_beshoy@yahoo.com Abstract Background: Lateral internal sphincterotomy is the ideal and gold standard surgical management of chronic anal fissure. The extent of lateral internal sphincterotomy is still a subject of discussion. Excess division of the internal sphincter leading to incontinence either to stool or flatus, so we must determine the extent of sphincterotomy. Subjects and methods: Between the period from February 2018 and October 2018 in the General Surgery Department of Zagazig University and El – Ahrar teaching Hospitals, 62 female patients with chronic anal fissure with mean ages of (34.1 + 8.2) and (41.8 + 9.05) of group A and B respectively complaining of chronic anal fissure. Group A of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy up to the fissure apex. Group B of (31) patients (50%) of study cases were subjected to lateral internal sphincterotomy to less than 1 cm from anal verge. Results: Group A showed complete fissure healing in 4 weeks (25) patients (80.6%) with (6 )patients cases comprising (19.35%) with delayed wound healing in 6 weeks .( 9 ) patients ( 29 % ) had transient incontinence to flatus . Group B showed complete fissure healing in 5 weeks (20) patients (64.5%) with (11 )patients cases comprising (35.5%) with delayed wound healing in 6 weeks .( 2) patients ( 6 % ) had transient incontinence to flatus Conclusions: In females with chronic anal fissure, division of internal sphincter must not exceed 1 cm from anal verge and not reach apex of the fissure to preserve the internal sphincter function and prevent incontinence either to stool or to flatus.

LATERAL SPHINCTEROTOMY UP TO THE FISSURE APEX VERSUS TO LESS-THAN 1CM FROM ANAL VERGE IN CHRONIC ANAL-FISSURE IN FEMALES