Outcome analysis of lateral sphincterotomy in the management of chronic anal fissure

ABSTRACT

To evaluate the post operative outcome, following lateral sphincterotomy for chronic anal fissure [CAF], in our set up. This prospective study was conducted in the Department of Surgery, Peoples Medical College Nawabshah from July 2005 to September 2009. A total of 80 patients with symptoms of CAF requiring surgery were included in the study having 48 males and 32 females, age ranged between 20-60 years. The diagnosis was made on clinical presentation and confirmed on pen anal examination; lateral sphincterotomy was performed under local or general aesthesia. Patients were followed on weekly bases to see any complication. All the cases of acute and complicated anal fissure were excluded from the study. Anal pain and bleeding. were the leading presentation found in 72 [91%] and 63 [78%] patients respectively, commonest site of fissure was posterior midline in 73 [92%] of cases. Post operative pain was observed in 5 [6%] cases, flatus incontinence in 15 [20%] patients, fecal incontinence in 3 [4%] cases, bleeding in only in 1 [1.2%] patients and infection was observed in 3 [4%] cases. Lateral sphincterotomy is the procedure of choice for the treatment of CAF. It has low rate of incontinence to stool and flatus, low recurrence and healing rate is faster. We advocate this procedure as an ideal treatment for CAF