TO DETERMINETHE EFFECTIVENESS OF LATERNAL INTERNAL SPHINCTEROTOMY IN THE TREATMENT OF CHRONIC ANAL FISSURE IN TERMS OF RECURRENCE
Objective: To determine the effectiveness of lateral internal sphincterotomy in the treatment of chronic anal fissure in
terms of recurrence.
Type And Place Of Study: This is a Prospective descriptive type of study and was conducted at Surgical department
of Hayatabad Medical Complex, Peshawar.
Duration Of Study. It was conducted from1st February 2011 to 31stJanuary 2012.
Patients And Methods. In this study a total of Fifty (50) patients with anal fissure were admitted through OPD.They all
underwent lateral internal sphincterotomy (closed or open)after elective surgery. They were discharged 48 hours after
surgery and the follow up was at 2nd week, 2nd and 6th months postoperatively. Patient’s symptoms and local anal
finding were noted questionnaire at each follow up.
Results: The Mean age of the patients at the time of presentation was 32.5(16-41) years; male to female ratio was
2.5:1. Pain persistedin 10%( 5) of patients. Bleeding was present in 8%(4),wound infection was in 10% (5) of patients
and recurrence of fissure was present in 6% (3) of patients. Also flatus incontinence and mild fecal soiling were present
in 6%(3) and 10%(5) of patients respectively.
Conclusion: Lateral internal sphnicterotomy is the quick and effective method of management for chronic anal fissure
regarding improvement of symptoms with low recurrence rate.
Key Words: Anal canal, anal canal tear, anal skin tag, hypertrophied anal papille, hypertonic anal sphinter, sphincterotomy