Prospective Randomized Study between Open Vs Closed Lateral Anal Internal Sphincterotomy in Patients with Chronic Fissure in Ano

Open Vs Closed Lateral Anal Internal Sphincterotomy

  • Anand Shanmugaiah Assistant Professor Department of General Surgery, Indira Gandhi Medical College and Hospital, Kathirkamam, Puducherry, India
  • Saravanan Pandian Assistant Professor, Department of General Surgery, Indira Gandhi Medical College and Hospital, Kathirkamam, Puducherry, India
Keywords: Anal Fissure, Postoperative Complications, Sphincterotomy


Background: One of the the most common cause of pain during defecationin young patientsis chronic fissure in ano. Surgical treatment of choice for chronic fissure in ano is internal sphincterotomy. This procedure can be performed by open or closed method. The aim of the study was to compare the closed and open anal internal sphincterotomy in patients admitted in our hospital with chronic anal fissure. Subjects and Methods: 105 patients admitted in department of general surgery with chronic fissure in ano were divided into two groups. 50 patients (Group A) who were treated by closed method and 55 patients (Group B) who were managed by open lateralanal sphincterotomy method. A 3 months follow up done in both post-surgery to observe for pain, bleeding, infection, incontinence, and recurrence. Results: Significant difference was observed in postoperative acute complications between the two methods of internal anal sphincterotomy. Conclusion: Lateral anal sphincterotomy is the treatment of choice for chronic anal fissure, either open or closed method. However, the closed method was observed to have lesserpost operative complication compared to the open method.


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