Lateral Internal Sphincterotomy for Chronic Anal Fissure under local anesthesia as a Day Case Surgery

Abstract

This prospective study was carried out in East Surgical unit, Mayo Hospital, Lahore for the period of two years from July 2001 to July 2002 on outpatient basis. Total of 50 patients aged between 20-50 years fulfilled the criteria of day case surgery i.e., health and social criteria (ASAI&II), only those were included in the study. The objectives were to evaluate the role of lateral sphicnterotomy under local anaesthesia as a day case surgery, considerable cost to patient and hospital, less morbidity and high patient acceptance. Thirty three patients (66%) were male and 17(34%) were female. Male to female ratio was about 2:1. Thirty nine patients (78%) presented with posterior anal fissure and 11 patients (12%) with anterior anal fissure. All patients operated under local anaesthesia as day case. Immediate relief from pain and painless first bowel movements was accomplished in 49(98%) of patients. No morbidity was observed. Postoperative complications were observed in 4 patients (8%) that resolved with conservative management. The patient acceptance was high (94%).