LATERAL INTERNAL SPHINCTEROTOMY VS ANAL DILATATION IN CHRONIC ANAL FISSURE; A COMPARATIVE STUDY

Abstract

Introduction: Anal fissure is a common problem with widespread presence in young adults and middle age group people. After the failure of conservative method there is a need of a good surgical procedure. Aim of this study is to determine the better surgical outcome between LIS and AD. Material and methods: This is a prospective observational hospital based study which included 65 patients of CAF in each LIS and AD group. They were followed for 3 months post-op for recurrence, pain relief and ulcer healing. Study was conducted after approval from ethics committee. Result: By the end of 2nd week, 99% patients of LIS group show pain relief with median VAS score of 1 and IQR of 0-1 while 93.84% patients in AD group with median VAS score was 1 with IQR of 0-2. (p-value=0.013). At one-month post-op 100% patients in LIS group shows healing of ulcer while in 92.3% in AD group. (p-value=0.068). At 3rd month LIS group show 4.6% recurrence while it is 27.7% in AD group, which is significantly higher with p-value>0.001. Conclusion: Both the surgical procedures are good with ulcer healing and pain relief but, LIS shows significantly higher pain relief than AD. In terms of recurrence LIS is a significantly far better procedure than AD. Overall LIS is a superior procedure for CAF than AD.