Comparison between lateral internal anal sphincterotomy and diltiazem in the treatment of chronic anal fissure

ABSTRACT

To compare lateral internal anal sphincterotomy with 2% diltiazem in the treatment of chronic anal fissure in terms of fissure healing and complications. Randomised controlled trial. Surgical unit Combined Military Hospital Lahore, from August 2008 to February 2009. Sixty patients were randomly assigned into two treatment groups. Group A was assigned to apply 2% diltiazem paste while, in group B lateral internal sphincterotomy [LIS] was done. Response to the treatment was assessed in terms of fissure healing, pain relief and occurrence of complications. Follow up of the patients was carried out at the end of 2[nd]d, 4[th], and 6[th] week of treatment. To compare lateral internal anal sphincterotomy with 2% diltiazem in the treatment of chronic anal fissure in terms of fissure healing and complications. In group A six patients had healing of fissure after 4 weeks and a further 4 at 6[th] week. In group B 14 patients had healing at 2 weeks, 10 at 4 weeks, and 5 at 6 weeks. One patient in group B and 20 in group A had no healing. In this study overall healing rate after 6 weeks with diltiazem was 33.33% and 96.66% with LIS. Lateral internal sphincterotomy is better than 2% diltiazem cream