Comparative Study of Lateral Internal Sphincterotomy vs Glyceryl Trinitrate Ointment for Fissure in Ano

Abstract

Aim To compare and find out the effectiveness of lateral internal sphincterotomy as well as glyceryl trinitrate in the treatment of anal fissure. Materials & Method A prospective study of 100 patients at the surgery department of a medical college and tertiary health care centre, over a period of 6 months that included cases of fissure in ano in the age group of 18 yrs and 70 years. They were randomly assigned to two different groups. One for surgery and the other for medical management with GTN. Each group had 50 patients in it. Results The pain relief of the patients after the surgical operation was fast and very satisfactory. On follow up at 2 weeks post operatively, pain and other symptoms were present in only 10patients (20%). Whereas the pain relief in medical management group was not fully satisfactory and it took more time.. and it was only temporary and how ever on follow up at 2 weeks, 15 patients came with recurrent pain and other symptoms.(30%). On follow up at 8 weeks, in both groups,all the 100 patients were symptoms free (100%) in this study. The complications that were observed during this study were soiling in 5 patients (10%) and incontinence to flatus in 2 patients (4%) in the surgical group and headache in 10 patients (20%) and peri anal itching in 4 patients (8%) in the medical management group.. how ever there was no recurrence of anal fissure observed in this study group. Conclusion From the above study, it is proved that lateral internal sphincterotomy is by far the best operation for pain relief and rapid cure for fissure in ano