Comparative study of Glyceryl Trinitrate ointment versus lateral internal sphincterotomy in management of Chronic anal fissure.

Abstract

Objectives: To compare efficacy of topical 0.2% glyceryl trinitrate ointment with lateral internal sphincterotomy in treatment of patients with chronic anal fissure. Study Design: Randomized Control Trial. Setting: Department of General Surgery, DHQ Teaching Hospital, Sahiwal. Period: From 20 September 2016 to 31 December 2017. Material & Methods: A total number of 60 patients included in this study and divided into two groups GTN and LIS group through computer generated randomization method. Three main outcome variables were assessed in this study; pain relief, healing of fissure and recurrence. SPSS version was used to analyze data. P value ≤ 0.05 was considered as significant. Results: A total number of 60 patients included in this study. Relief of pain GTN and LIS was (95%) and (86.7%) respectively. Fissure healing GTN and LIS was noted as (88.3%) and (83.3%) respectively. Recurrence was not found in any patient of the present study. Relief of pain was statistically significant. Conclusion: Topical application of GTN ointment for relief of pain is safe and effective method for relief of chronic anal fissure but pain relief is slow. On other hand lateral internal sphincterotomy is first line treatment and treatment of choice for chronic anal fissure when performed by an experienced surgeon.