Lateral Internal Sphincterotomy for Chronic Anal Fissure under local anesthesia as a Day Case Surgery

Siddique, Tariq; Khan, Sadaqat Ali; Rehman, Madeha; Islam, Haroon Rafiul; Ahmad, Waseem

doi:10.21649/akemu.v9i1.1322

Cited by 2 publications

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“…Conservative LIS under local anesthesia was found effective in more than 98% of patients 14 . Incontinence to flatus was seen in only one patient and no patients developed fecal incontinence 17 .…”

Section: Discussionmentioning

confidence: 95%

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What is the optimum treatment of chronic anal fissure?

Khan¹,

Arif²,

Nofil³

et al. 2021

PJMHS

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Aim: To compare the efficacy of topical Glyceryl trinitrate 0.2% (GTN) with Lateral internal spincterotomy (LIS) for treating chronic anal fissure (CAF). Methodology: A randomized control trial was carried out in the general surgery department, Lady reading hospital, LRH MTI, Peshawar (January 2018 to July 2018). All consecutive patients 18 to 60 year old presenting to OPD with a clinical diagnosis of chronic anal fissure were enrolled after informed consent. A total of 60 patients were enrolled. The patients were assigned two groups, including treatment group A (lateral internal spinterotomy) or treatment group B (use of Topical GTN ointment 0.2%). Results: Out of the 60 patients, 30 were enrolled into each group. The female had majority of 57% (group A) and 60% (group B). Mean duration regarding symptoms in group A was 1 year with SD ± 3.51 vs 1 year ± 2.98 in group B. Majority of patients in both groups were in the 20 to 40 years age group (74% in group A vs 83% in group B). Complete fissure healing and resolution of symptoms was observed in 27(91%) in group A vs 20(66%) in group B. Conclusion: In conclusion, we derive that lateral internal spincterotomy is more effectual than Topical Glyceryl trinitrate 0.2% for treating chronic anal fissure. Keywords: Chronic anal fissure, lateral internal spincterotomy, Glyceryltrinitrate

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Section: Discussionmentioning

confidence: 95%

“…LIS is a gold standard treatment for anal fissure 12 . It is also safely effective in treating CAF 12,14 . In a study it was shown that only 4% of the patients initially healed with 0.2% GTN and had to undergo sphincterotomy for recurrences 13 .…”

Section: Discussionmentioning

confidence: 99%

What is the optimum treatment of chronic anal fissure?

Khan¹,

Arif²,

Nofil³

et al. 2021

PJMHS

View full text Add to dashboard Cite

show abstract

“…The patients were operated as a daycare procedure using local anaesthesia. With the exception of 1 (2%) patient, all the patients 49 (98%) had sudden pain relief and passed first stool after surgery without pain 20 .…”

Section: Discussionmentioning

confidence: 96%

Lateral Sphincterotomy Under Local Anaesthesia; A Safe and Time- Efficient Alternative Without Compromising Patient Satisfaction

Haider

Owais

Abbas

et al. 2021

ashkmdc

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Objective: The objective of this study was to find out whether Lateral Internal Sphincterotomy (LIS) can be carried out using Local Anaesthesia (LA) hence, lowering down the cost and anaesthesia related complications in patients without compromising operative easiness or final result.Methods: One hundred patients who were diagnosed clinically as anal fissure patients and were scheduled for LIS were randomly distributed into two treatment arms. Non-probability consecutive sampling approach was employed. In the first group, LIS was carried out using LA while in the second group LIS was performed in spinal anaesthesia (SA). Age, gender, BMI, procedure time, post-operative complications like pain, post-operative nausea and vomiting (PONV), bleeding, headache, incontinence, urinary retention and patient satisfaction were the main outcome variables which were studied.Results: Out of 100 patients who were treated with LIS, 50 of these patients had SA whereas, the rests of the 50 patients were given LA. We found no statistically significant difference in the post-operative pain, PONV, bleeding, incontinence, and overall patient satisfaction but duration of surgery and post-operative complications like headache and retention of urine were considerably less in the LA group. The difference between the two groups dictated that LIS under local anaesthesia (Group A) took 13.46 minutes (SEM 0.808) lesser than Group B which was statistically significant. But the Mean postoperative pain scores of patients in both groups were not significantly different on statistical analysis nor pain scores at 12 hours from surgery and 24 hours from surgery separately i-e 'p-value>0.05'Conclusions: LIS under LA is less time-intensive, safe and has a comparable patient satisfaction rate to SA. Besides, the advantage of significant cost benefit, duration of surgery, exemption of the requirement of an anaesthetist, and less post-operative headache and PONV, LA also shows no noteworthy difference in the post-operative complications in comparison with SA.

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Lateral Internal Sphincterotomy for Chronic Anal Fissure under local anesthesia as a Day Case Surgery

Cited by 2 publications

References 0 publications

What is the optimum treatment of chronic anal fissure?

What is the optimum treatment of chronic anal fissure?

Lateral Sphincterotomy Under Local Anaesthesia; A Safe and Time- Efficient Alternative Without Compromising Patient Satisfaction

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