Outcome of Lateral Internal Sphincterotomy in the Management of Chronic Fissure in Ano

Kamran Aslam, Quandeel Arshad, Aisha Imran


Objective: to assess the outcome of lateral internal Sphincterotomy in the management of chronic fissure in ano.Study Design: Cross sectional StudyStudy Place and Duration: Department of General Surgery Nishtar hospital, Multan, POF Hospital Rawalpindi and Holy Family Hospital Rawalpindi from 12th January 2018 to 15th July 2018.Material and methods: A total number of 140 patients were enrolled in the study. Data regarding age, sex, day of operation, duration of postoperative hospital stay, position of the fissure in ano and mean follow up period was measured and recorded in the form of a performed performa. A designed questionnaire was provided to the patients, which contained questions regarding the level of satisfaction, need of further treatment, leakage of gas, fluid or feces and development of symptoms consistent with the symptoms of the previous fissure in ano. Data analysis; the data thus obtained was subjected to statistical analysis using computer software SPSS version 23. Frequency and percentages were calculated for qualitative variables while mean and standard deviation was calculated for quantitative variables.Results: Postoperatively, 17 (12.1%) patients complained of painful defecation and 9 (6.4%) patients complained of bleeding and only 12 (8.6%) needed medical treatment for these complaints. Postoperative incontinence to flatus was seen in 11 (7.8%) patients and 8 (5.7%) patients complained of incontinence to flatus and fluids. Only 2 (1.4%) patients complained of incontinence to feces. Overall new incidence of incontinence was seen in 5 (3.6%) of the patients.Conclusion: Outcome of lateral internal sphincterotomy are excellent as it is associated with a very low rate of incontinence, bleeding or painful defecation postoperatively and thus it improves the quality of life among the patients of chronic fissure in ano. It can be suggested that lateral internal Sphincterotomy is a safe and effective procedure for chronic fissure in ano.

Keywords: Outcome, Lateral, Internal, Sphincterotomy, Management, Chronic, Fissure, Anal

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