The outcome of Closed Lateral Internal Sphincterotomy for the chronic Anal Fissure

Abstract

The aims and objectives of the study are to determine the efficacy of closed lateral internal sphincterotomy to relieve symptoms of chronic anal fissure and postoperative complications of procedure. The study was conducted at Surgical Department, Sir Ganga Ram Hospital, Lahore over a period of two years from April, 2001 to Feb., 2003. The first 100 consecutive patients of either sex irrespective of age were included in this study. All these patients were with symptomatic, anal fissure, with failed medical treatment and long history. All these patients were operated under spinal and general anesthesia in lithotomy position. Digital examination and proctoscopic examination was done. Among 100 patients 56 patients (56%) were free of pain within 24 hours and 42 patients (42%) had no pain after 48 hours. Two patients (2%) complained of persistent moderate to severe pain. Among 100 patients 6 patients (6%) had haemorrhage with soakage of gauze piece but there was no active bleeding. Only oozing was detected. Two patients (2%) had hematoma at operative site. Four patients (4%) C/o impaired control for flatus and soiling of underwear but these recovered within hospital stay. Closed internal sphincterotomy is a procedure of choice for chronic anal fissure. It is minimally invasive procedure. Postoperative discomfort is of shorter duration, wound heals quickly and recurrence is uncommon.