Comparision of Postoperative Complications Associated with Closed Lateral Sphincterotomy and Fissurectomy with Dorsal Sphincterotomy in Chronic Anal Fissure

Abstract

Background: Chronic anal fissure is clinical entity associated with significant pain and discomfort with bleeding. Different surgical options are being used nowadays to treat the ailment. Closed lateral sphincterotomy is being considered as gold standard treatment however, dorsal sphincterotomy with removal of chronic fissure is also used as treatment. Objectives: To compare effectiveness and patient satisfactions after both surgical procedures. To identify the common complications associated both surgical procedures. Methodology: The cross sectional conducted at Ghulam Muhammad Maher Medical College Sukkur from January 2016 to December 2019. Total 300 male patients with history of Chronic Anal Fissure for more than 6 months were included in the study. The patients were divided into two groups Group-A (150 patients) underwent lateral sphinterotomy whereas in Group-B (150 Patients) dorsal sphincterotomy with fissurectomy was performed. Randomization for grouping was performed by single blind sealed envelope technique. Patients with additional anorectal disease, haemorrhoids, HIV, HBV, HCV, and female patients were excluded from study. After performing surgery in both the groups follow-up was performed for 2 years and data was analyzed. Results: Mean age was 30.5 4±12.3 years, most common site of fissure among our study population was 6 O’ Clock (p-value=0.003), pain was seemed to be significant post-operative completion in both the groups however, both the treatment strategies appeared to be equally effective though patients in group B were more satisfied than group A.   Conclusion: Both methods of surgeries seemed to be equally effective in treating the ailment. Recurrence after both surgeries was uncommon though pain was common postoperative complication.