Volume 8

Number 1 January 2024

A Comparison of outcome of Lateral Internal Sphincterotomy and Chemical Sphincterotomy for Treatment of Chronic Anal Fissure

DOI: https://doi.org/10.70357/jdamc.2024.v0801.04

Ahmad MS1 , Alam R2 , Isam MN3 , Shahana Ahmed4 , Nurunnabi M5

Abstract

Background: Lateral Internal Sphincterotomy (LIS) is considered the gold standard for surgically managing chronic anal fissures when conservative and medical treatments fail. It is highly effective in curing anal fissures, but it is associated with a high incidence of postoperative incontinence.

Objective: To compare the effectiveness of B and chemical sphincterotomy (CS) in the treatment of chronic anal fissure.

Methods: A randomized controlled trial was conducted among the 70 purposively selected patients, aged 15-50 years, diagnosed with chronic anal fissure. The patients were divided equally into two groups, each containing 35 patients: a lateral internal sphincterotomy (LIS) group and a chemical sphincterotomy (CS) group. Data were collected from January 2014 to December 2015 at both government and private hospitals in Faridpur, Bangladesh.

Results: After 3 months, 34 patients in the LIS group achieved complete healing of the fissure compared to 13 patients in the CS group. By the 6-month mark, 6 patients in the CS group had experienced healing. Additionally, one patient in the LIS group required further surgery for a superficial fistula, while 9 patients in the CS group needed an internal sphincterotomy. Compliance issues were notable in the ointment group due to slower healing and a prolonged duration for symptom relief. Minor incontinence occurred in 5.7% of the LIS group and was absent in the CS group.

Conclusion: Lateral internal sphincterotomy is the best treatment option for chronic anal fissures due to its early symptom relief, quick fissure healing, and improved patient compliance.

Keywords: Anal fissure; lateral internal sphincterotomy, glyceryltrinitrate; sphincterotomy


  1. Associate Professor, Department of Surgery

    Diabetic Association Medical College, Faridpur

  2. Breast and Colorectal Surgeon, Department of Surgery

    Diabetic Association Medical College, Faridpur

  3. Assistant Professor, Department of Surgery

    Diabetic Association Medical College, Faridpur

  4. Associate Professor, Department of Gynae and Obstetrics

    Diabetic Association Medical College, Faridpur

  5. Assistant Professor, Department of Community Medicine

    Sylhet Women’s Medical College, Sylhet

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Volume 8, Number 1 January 2024
Page: 14-17