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

By convenience (non probability) sampling 60 patients of anal issure were divided into two equal groups, one each for manual dilatation and lateral internal sphincterotomy. Anal issure secondary to speciic pathology i.e. syphilis, tuberculosis, crohn's disease were excluded from study. Data was collected on speciic proforma and was put to "SPSS" version 10.0-on computer. It was analyzed for frequency, percentages and mean standard deviation. Chi-square test was applied and p 0.05 was considered signiicant. 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 sphincterotomy 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 signiicant. Flatus incontinence, cloth soiling and recurrence were signiicantly less in lateral internal sphincterotomy group. Fissure healing was much better in lateral internal sphincterotomy group with signiicant 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 issure. 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 unavoidable in manual anal dilatation.