Umer Farooq, Sumaiya Farooq, Sana Zahir, Abdul Majeed Chaudhry.
Comparison of surgical and chemical sphincterotomy in the management of acute anal fissures.
Pak J Med Health Sci Jan ;6(1):24-31.

Objective: To compare the results and outcome of chemical and surgical sphincterotomy in the management of acute anal fissure. Study design: Quasi experimental study. Place and duration: The study was carried out in the department of surgery, Sir Ganga Ram Hospital, Lahore, from 20-08-2007 to 19-08-2009. Sample size: Total 100 patients of acute anal fissures Materials and methods: Patients who gave informed consent were randomized into two groups. Fifty patients in group A underwent chemical sphincterotomy and 50 patients in group B underwent surgical sphincterotomy. They were followed up for a period of 3 months and results of two treatment modalities were compared. Results: Surgical sphincterotomy showed early symptomatic relief within 6.08+2.83 days as compared to 9.23±7.89 days by chemical sphincterotomy. Hundred percent healing rates were observed with surgical sphincterotomy as compared to 54%with chemical sphincterotomy. Conclusion: Surgical sphincterotomy is better than chemical sphincterotomy in the management of acute anal fissure in terms of early symptomatic relief and high healing rates. However, chemical sphincterotomy heals 54%ofpatients in out patient setting, associated with less work loss that is no hospital admission is required, so it has a definite role in the management of acute anal fissure.

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