Journal of AdvancedMedical and Dental Sciences Research

Aim: To compare the lateral internal sphincterotomy versus anal dilatation in chronic anal fissure. Methods: After receiving ethical approval from the institution, the research was carried out at the department of General Surgery. This research comprised 100 patients aged 20 to 52 years, with CAF and failed medical treatment. All of the patients were separated into two groups of 50 each. CAF was characterised as an anal ache for 8 weeks with induration of the borders of the fissure and exposure of the fibres of the internal sphincter in the floor of the fissure with sentinel tag. Results: The LIS group had considerably fewer patients with the highest pain level at 24 hours after surgery than the LAD group (p value-0.02, or 6.5, 95 percent CI- 1.58-21.87). However, there was no significant difference in pain scores between the two groups were examined later, i.e. before discharge, one month, three months, and six months (p values- 0.72, 0.77, and 0.47). 40 (80%) of the LAD group and 44 (88%) of the LIS group had bleeding in the first 24 hours after surgery, which was clinically insignificant and diminished in future days, but was not determined to be statistically significant (p value 0.34) The average post-operative hospital stay in the LAD group and the LIS group is 3.5 days and 3.7 days, respectively. After three months of therapy, full healing was reported in 47 patients and incomplete in the remaining three patients in the LAD group, while complete healing was observed in 48 patients and incomplete in two patients in the LIS group. Conclusions: With only a minor difference in pain and Lord's dilatation compared to sphincterotomy, and no findings of incontinence or situations resulting in sphincter damage, we conclude that LAD is appropriate for patients with chronic anal fissures because it is less invasive than LIS and has equivalent efficacy and safety.