A comparative study of the results of the lateral internal anal sphincterotomy vs manual dilatation of anus for chronic anal fissure.

  • Allah Nawaz Sargodha Medical College, Sargodha.
  • Khalid Mahmood Sargodha Medical College, Sargodha.
  • Nazim Hayat University Medical & Dental College, Faisalabad.
  • Ahmad Hassan Khan Sargodha Medical College, Sargodha.
  • Asad Rizwan Rana Sargodha Medical College, Sargodha.
  • Raza Farooq Sargodha Medical College, Sargodha.
Keywords: Anal Sphincter, Chronic Anal Fissure, Lateral Internal Anal Sphincterotomy, Manual Dilatation of Anus

Abstract

Objectives: To compare the results of surgical treatment of chronic anal fissure after lateral internal sphincterotomy with manual dilatation of anus. Study Design: Randomized Controlled Prospective study. Setting: Department of Surgery District Teaching Hospital Sargodha, Pakistan. Period: April 2018 to Feb 2019. Material & Methods: Patients were divided into two groups by lottery method. The procedures were performed using standard protocols after obtaining written informed consent. 50 patients underwent lateral internal anal sphincterotomy (Group 1) and 50 patients manual dilatation of anus (Group 2). Patients having atypical anal fissures associated with other diseases were excluded from this study. We assessed both groups for persistence of symptoms, complications and better satisfaction in terms of surgical techniques. Results: All patients became symptoms free within 07-14 days of surgery. Urinary retention was noted in 2(4%) patients in lateral internal sphincterotomy and 2(4%) in manual dilatation of anus. Temporary flatus Incontinence was noted in 2(4%) patient of lateral internal sphincterotomy and 2(4%) in manual dilatation of anus. Faecal soiling was observed in 1(2%) patient of lateral internal sphincterotomy. No recurrence, anal stenosis, hemorrhage, infection of wound, pain and bleeding associated with defecation was seen in both groups. Conclusion: Both lateral internal sphincterotomy and manual dilatation of anus techniques are effective.

Author Biographies

Allah Nawaz, Sargodha Medical College, Sargodha.

MBBS, FCPS

Assistant Professor Surgery

Khalid Mahmood, Sargodha Medical College, Sargodha.

MBBS, FCPS

Assistant Professor Surgery

Nazim Hayat, University Medical & Dental College, Faisalabad.

MBBS, FCPS

Associate Professor Surgery

Ahmad Hassan Khan, Sargodha Medical College, Sargodha.

MBBS, FCPS

Associate Professor Surgery

Asad Rizwan Rana, Sargodha Medical College, Sargodha.

MBBS, DA

Assistant Professor Anesthesia

Raza Farooq, Sargodha Medical College, Sargodha.

MBBS, DA

Assistant Professor Anesthesia

Published
2020-11-10