Comparative study of closed versus open lateral internal sphincterotomy in the management of chronic anal fissure

Bansal, Anand; Bansal, Manish; Bhardwaj, Ankit

doi:10.18203/2349-2902.isj20201389

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…As can be seen in our study (71.3% of patients were male) and in some other studies, men are more likely to be affected than women. Although the exact aetiology of the anal fissure is unknown, trauma due to hard faecal matter and hypertonicity of the internal sphincter are believed to be the initial factors [14][15] . Despite these findings, only 31.3% of patients with chronic anal fissure suffer from constipation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Lateral Internal Sphincterotomy in Treating Chronic Anal Fissure

Faizan¹,

Ahmad²,

Zafar³

et al. 2022

PJMHS

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Aim of the study: To determine the effectiveness of lateral internal sphincterotomy in the treatment of chronic anal fissures resistant to pharmacological treatment (chemical sphincterotomy) in terms of recovery time, frequency of recurrences and complications. Study design: This was a prospective descriptive study. Place and duration:In the Department of Surgery,Lahore General Hospital, Lahore during the time period fromJanuary 2021 to August 2021. Material and methods: The study included 80 patients with chronic anal fissure, regardless of age and sex, after the history and clinical examination. All these patients were operated on under general or spinal anesthesia after obtaining consent and routine examinations. Lateral internal sphincterotomy was performed and patients with OPD were followed for 6 to 8 weeks to determine the benefit of the procedure. Results: The study included 57 men and 23 women (M: F ratio 2.2: 1) with a history of pain, bleeding, discharge with or without sentinel tagduring defecation. The average age was 36 and ranged from 20 to 55. The fissure was found in the majority of patients at 6 O clock position (91.2% for men and 52.2% for women). The duration of symptoms was longer in women due to social problems. LIS was used in all patients. Patients were followed in OPD at weeks 1, 2, 4 and 6. Most of the patients fully recovered after 4 weeks. Occasional constipation occurred in 31 (54.4%) men and 11 (47.8%) women. The study found crater ulcers in all 80 patients. All patients had a history of painful bowel movements (100%), but 24 men (42.1%) and 12 women (52.2%) had bleeding and discharge. In 51 male patients (89.5%), the fissure was in the posterior and anterior midline in 3 patients (13.1%). Half of the patients had anterior fissure and the other half had posterior fissures. The sentinel tag was observed in 46 (80.7%) men and 17 (73.9%) women. 11 (19.3%) men and 6 (26.1%) women reported liquid stool incontinence, while 15 men (26.3%) and 9 women (16.9%) reported flatus incontinence. No relapse was observed in all patients after 4 months. Conclusion: As long as the patient is willing to accept the risk of transient fecal incontinence, we can accept the Gold Standard of Treatment (LIS) as first-line therapy for chronic anal fissure. Keywords: Lateral internal sphincterotomy, Chronic anal fissure, Fecal incontinence.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Lateral Internal Sphincterotomy in Treating Chronic Anal Fissure

Faizan¹,

Ahmad²,

Zafar³

et al. 2022

PJMHS

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Comparative Study of Open Lateral Internal Sphincterotomy versus Closed Lateral Internal Sphincterotomy in Fissure in Ano

Pathak,

Dikshit,

Mohite

et al. 2022

Indian Journal of Colo-Rectal Surgery

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Background: Among many treatment modalities for a chronic anal fissure, lateral internal sphincterotomy remains the first line of treatment. It is performed by the closed and open methods. Until now, no definitive guidelines have been shown on the choice of open or closed technique for performing lateral internal sphincterotomy. The aim of the present study was to compare the outcome of open and closed techniques of lateral internal sphincterotomy in the treatment of anal fissure. Materials and Methods: Ninety patients aged between 20 and 75 years were included in this single-blind randomized controlled study. Group A patients underwent open lateral internal sphincterotomy (OLIS), whereas Group B patients underwent closed lateral internal sphincterotomy (CLIS). The primary outcome measure was the healing of fissure, whereas secondary outcome measures were severity of pain by the Visual Analog Scale score and per rectal bleed postoperatively. The intergroup comparison of categorical and continuous variables was done using the Chi-square test/Fisher’s exact test and unpaired t-test, respectively. Results: There was no statistically significant difference between the OLIS and CLIS groups in relation to the severity of the postoperative pain, postoperative per rectal bleeding, and the healing of fissure on direct rectal examination. Conclusions: There was no difference between OLIS and CLIS in fissure-in-ano with respect to surgical outcome.

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Comparative study of closed versus open lateral internal sphincterotomy in the management of chronic anal fissure

Cited by 2 publications

References 5 publications

Efficacy of Lateral Internal Sphincterotomy in Treating Chronic Anal Fissure

Efficacy of Lateral Internal Sphincterotomy in Treating Chronic Anal Fissure

Comparative Study of Open Lateral Internal Sphincterotomy versus Closed Lateral Internal Sphincterotomy in Fissure in Ano

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