Early Outcome of Closed Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissure Compared to Open Method.

Abstract

Lateral internal sphincterotomy (LIS) has long been regarded as the standard treatment for chronic anal fissure (CAF). Both open and closed methods are practiced for LIS. In this study evaluated and compared the early clinical outcome in terms of patient morbidity and procedure related complications of both the methods. This was a quasi-experimental study conducted in the department of Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh (SSMCMH), Dhaka, Bangladesh from May 2018 to April 2019. Fifty (50) patients of chronic anal fissure had been chosen purposively and divided into two groups. Experimental group had 25 patients who underwent closed LIS and Control group had 25 patients who underwent open LIS. All patients were followed up at 2 weeks' and 6 weeks' after surgery. Mean duration of operation in closed method was 8.40±2.10 minutes and in open method 13.48±1.76 minutes, which was significant (p<0.001). Post-operative pain at different time interval was lower in experimental group and significantly lower at 48th hour with a p-value of 0.002. Closed LIS is a safe and time worthy method with less patient morbidity and less post-operative complications for the treatment of CAF.