Efficiency of Lateral Internal Anal Sphincterotomy by Closed Method Under Local Anaesthesia as an Out Patient Procedure

Chronic anal fissure is one of the main proctological disorders encountered in surgical outpatient departments, dueto its high prevalence and the great discomfort involved.Though, the exact aetiology of primary anal fissure is stillunknown, high resting anal pressure caused by increased internal sphincter tone appears to be the underlying pathological factor. So, the aim of this study is to determine the efficiency of the procedure of lateral internal sphincterotomy by closed method under local anaesthesia as an outpatient procedure. The clinical study was undertaken in allpatients (70 patients, mean age 35 years) undergoing lateral closed sphincterotomy for chronic anal fissure (definedas anal fissure with > 6 weeks symptoms duration) from June 2005 to May 2006 who presented to Surgical OPD,in our hospital. Among 70 studied patients, 41 (58.5%) were females and 29 (41.4%) males. Age ranged from 16-63years with the mean age of 35 years. Post-operatively, early complications included minor bleeding in two patients(3.4%) and incontinence of flatus in five patients (8.6%). In all the patients in our study lateral internal sphincterotomy was performed under local anesthesia and they were followed up for 4 months. 88% of patients were cured oftheir symptoms while only in 12% the fissure failed to heal. Lateral internal anal sphincterotomy by closed methodunder local anesthesia as an outpatient procedure has very good results in patients with chronic anal fissure who donot respond to conservative treatment.