Comparison of lateral internal sphincterotomy with 0.2% glyceryl trinitrate in the management of chronic anal fissure

ABSTRACT

To compare the effectiveness of topical Glyceryl trinitrate Ointment with Lateral internal Sphincterotomy in terms of relief of pain healing of fissure and absence of bleeding over a period of two months. Randomized controlled trial. Department of Surgery, Combined Military Hospital Peshawar from Feb 2007 to August 2007. This study included 80 patients of chronic anal fissure. Patients were randomly divided in two groups with 40 patients in each group. One group was prescribed with 0.2% GTN Ointment intra anally 4 times a day for 8 weeks in OPD [group A]. Second group was admitted in Surgical ward and lateral internal sphincterotomy was performed on each patient by open technique under general anaesthesia [group B]. In Group A 33 [82.5%] patients had healed fissure at the end of 8 weeks While in group B 37 out of 40 [92.5%] patients had healed fissure at the end of 8 weeks. 0.2% Glyceryl trinitrate can be offered as first line of treatment for chronic anal fissure which means that surgery can be avoided in more than 82% of the patients