Comparative study of lateral internal sphincterotomy with anal dilatation for the treatment of chronic anal fissures

ABSTRACT

To compare the results of lateral internal sphincterotomy with anal dilatation in chronic anal fissure. Interventional study. It was carried out in surgical department of PNS Shifa hospital Karachi, from October 2003 to September 2004. The first 80 consecutive patients of either sex irrespective of age were included in this study. All these patients were with chronic anal fissure, with failed medical treatment and long history. They were divided into two groups each comprising 40 patients. Group A had lateral internal sphincterotomy [LIS] and Group B had anal dilatation [AD]. All these patients were operated under spinal / general anesthesia in lithotomy position. LIS was associated with remarkably low incidence of postoperative complications. Anal incontinence was seen in 12.5% and recurrence in 2.5% of patients in case of LIS, while the corresponding figures for AD were 50% and 7.5% respectively. LIS being a superior surgical procedure than AD should be the procedure of choice in chronic anal fissures