Closed compared with Open Lateral Internal Sphincterotomy in Anal Fissure - a prospective single centre study outcomes at our Base Teaching hospital, srinagar (uttarakhand).

K.P.Singh; S.Prakash; K.Amit

Volume : VII, Issue : III, March - 2018

Closed compared with Open Lateral Internal Sphincterotomy in Anal Fissure - a prospective single centre study outcomes at our Base Teaching hospital, srinagar (uttarakhand).

K. P. Singh, S. Prakash, K. Amit

Abstract :

Aim: Anal fissure is usually common in middle age groups& associated with severe pain in anal area during act of defaecation. Lateral internal sphincterotomy(LIS) has been considered the treatment option for chronic anal fissure(CAF) since years. In this study; our aim was to compare & asses the outcomes of closed& open techniques of LIS at our centre.

Material and Methods: Total 183 patients underwent for operative interventions after prospective randomization considering 98 patients for closed lateral internal sphincterotomy(CLIS) & 85 patients for open lateral internal sphincterotomy(OLIS) with diagnosis of chronic anal fissure. Z–Test was used for calculation of p–values.

Result: As compared to OLIS, CLIS was associated with less operating time( 3.61 vs7.6 minutes, p<0.01) shorter hospital stay (3.03 vs 5.58 days), normal activity(4.17 vs 6.02 days, p<0.05) with less incontinence(3vs14, p<0.01)& recurrences(4vs8,p<0.05). The need of analgesic either by iv (2doses Vs 4doses,p<0.01)or oral (CLIS:2doses,OLIS:6doses,p<0.01) route was also less in (CLIS) groups.

Conclusion: We conclude that CLIS for chronic anal fissure is safe & beneficial operative procedure & post^–op. outcomes including hospital stay was significantly short with fewer rate of infection,incontinence &recurrences.