Closed anal sphincter manipulation: an alternative to anal stretch or sphincterotomy in chronic anal fissure

ABSTRACT

To assess the outcome of Closed Manipulation of the fibers of the internal anal sphincter in cases of Chronic Anal Fissures. Prospective, descriptive study from Jan. 2005 to July 2005. Setting: Gupta Nursing Home, Laxminagar, Nagpur, India. 48 patients with Chronic Anal Fissure. The patients underwent history taking, examination and investigations. Pre-operative and post-operative anal manometry was performed. Post-operative complications were noted, and early and 6-months follow-up results were recorded. Fissure healing and relief of symptoms was observed in 94% of the patients. The notable complications included ecchymosis and haematoma. A transient, variable degree of incontinence occurred in three patients. Manipulation of internal anal sphincter is an easy, safe and effective procedure for the treatment of Chronic Anal Fissure