A STUDY COMPARE POST-OPERATIVE PAIN & INCONTINENCE BETWEEN LATERAL INTERNAL SPHINCTEROTOMY VERSUS ANAL DILATATION IN CHRONIC ANAL FISSURE

Dr. Neeraj Kumar Banoria; Dr. Satyendra Kumar; Dr. Shiv Ankip

Volume : IX, Issue : VII, July - 2020

A STUDY COMPARE POST-OPERATIVE PAIN & INCONTINENCE BETWEEN LATERAL INTERNAL SPHINCTEROTOMY VERSUS ANAL DILATATION IN CHRONIC ANAL FISSURE

Dr. Neeraj Kumar Banoria, Dr. Satyendra Kumar, Dr. Shiv Ankip

Abstract :

Background and Objectives: Both anal dilatation (AD) and lateral internal sphincterotomy (LIS) are practiced in our hospital for treatment of chronic anal fissure (CAF). The objective of the study was to compare the two procedures especially regarding pain relief, ulcer healing, incontinence and recurrence. Material and Methods: This is an observational study and included 49 patients of AD (Group A) and 49 patients of LIS (Group B). The average follow-up was 1-6 months. Results: By the end of 1 month pain relief was observed in 44 (89.8%) and 47 (95.91%) patients and ulcer healing in 44 (89.79%) and 46 (93.87%) patients in group A and B respectively. By the end of 3 months, minor incontinence including mucous discharge was observed in 13 (26.5%) and 3 (6.12%) patients in group A and B respectively and the difference was significant (p=0.0062). None had major incontinence. Nine (18.36%) and 1 (2.04%) patients in group A and group B respectively reported with recurrence (p = 0.0075) during the study period and thereafter. Conclusion: Both AD and LIS provides early pain relief and high ulcer healing rate. However, LIS appears to be safer with regard to incontinence, and the chance of recurrence is also lower compared to AD.