Management of the anal fissure: a comparison between lateral internal sphincterotomy with manual dilatation of anus

Abstract

Design: It was a comparative study of randomly selected sample of 50 patients. Purpose: To compare the results of lateral internal sphincterotomy with manual dilatation of anus under general anaesthesia in the management of fissure in ano in terms of (Relief of symptoms, Post operative complications). Place & Duration of study: Patients presented to Surgical unit, Bahawal Victoria Hospital, Bahawalpur from 15-02-2002 to 14-02-2004. Material & methods: This was a prospective type of comparative study. The patients of fissure in ano were randomly divided into two groups. Group A patients were treated by lateral sphincterotomy & Group B patients were treated by manual dilatation of anus under anesthesia. Follow up protocol was also maintained. Patients were examined and evaluated according to the comparison criteria which were (Relief of symptoms, Complications developed, Recurrence & Healing of fissure). Result: Out of these 50 patients, 32 were male and were female. In Group-A, 92% of patients were completely cured, 4% of patients developed retention of urine while 4% of patients developed post-operative bleeding. The success rate was 92%. In Group-B, success rate was 72% out of remaining 8% developed incontinence of flatus, 8% developed incontinence of faeces, 4% developed retention of urine while haematoma was observed in 4% of cases.The data was analysed with "SPSS" on computer, Standard Error of Difference Between Two Proportions was applied. Chi square test was applied and P value found to be 0.04 which is less than 0.05 (Statistically insignificant). Conclusion: On the basis of this study, it was concluded that the results of Lateral Internal Sphincterotomy in the management of anal fissure is safer and more effective than manual dilatation of anus under anaesthesia.