Outcome evaluation of lateral internal sphincterotomy versus manual dilatation of anus in anal fissure

By convenience (non probability) sampling 60 patients of anal fissure were divided into two equal groups, one each for manual dilatation and lateral internal sphincterotomy. Anal fissure secondary to specißic pathology i.e. syphilis, tuberculosis, crohn’s disease were excluded from study. Data was collected on specific proforma and was put to “SPSS” version 10.0- on computer. It was analyzed for frequency, per- centages and mean ± standard deviation. Chi-square test was applied and p = 0.05 was considered signifi- cant. In this study 30 patients were male and 30 were females. Minimum age was two years and maximum was 70 years with mean ± standard deviation of 33.60 ± 14.88. Duration of symptoms was from 4 to 18 months with mean ± standard deviation of 10.38 ± 4.488. in thirty patients, lateral internal sphinctero- tomy was done and manual anal dilatation was done to others. In 14 patients existing posterior anal tag was also removed. In one patient haemorrhoidectomy and lateral internal sphincterotomy were simultaneously done with good results. Complete pain relief was found in 29 patients in lateral internal sphincterotomy group as compared to 17 patients of manual anal dilatation group with p = 0.001 which is highly signißicant. Flatus incontinence, cloth soiling and recurrence were signißicantly less in lateral internal sphincterotomy group. Fissure healing was much better in lateral internal sphincterotomy group with signißicant p value of 0.002.The results of the present study concluded that lateral internal sphincterotomy is surgical treatment of choice for patients with anal ßissure. It has a very high cure and very low complication rate as compared to manual anal dilatation. At the same time, it avoids damaging external anal sphincterotomy which is un- avoidable in manual anal dilatation.