Tamjeed Gul, Mah Muneer Khan, Maryam Alam Khan, Uzma Andaleeb, Sana Sahar.
Comparison of controlled-intermit ent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective randomized study.
Pak J Surg Jan ;32(4):218-22.

Objectives: To compare lateral internal sphincterotomy (LIS) with controlled intermittent anal dilatation (CIAD) in terms of patient satisfaction Design: Prospective randomized controlled study Place and duration of study: Khyber Teaching Hospital, Department of Surgery, March 2014 to March 2015. Patients and methods: 48 patients were randomly allocated into two groups. 20 patients in group A underwent LIS while 28 patients in group B had CIAD. All patients were evaluated pre-op, at first bowel movement and followed till 10th post-operative day for pain during defecation Results: Mean age in group A was 38.40 years ±13.9 and 35.56 ±13.96 in group B. Anterior fissure was more common in both groups as compared to posterior (70% vs 30%) and (53% vs 42%). The VAS score at first post-op defecation was comparable but significantly reduced in Group A on 10th post operative day (1.05±0.22 vs 1.26±0.44) p= 0.059. Conclusion: The two procedures have comparable results in terms of patient satisfaction, although LIS is gold standard, CIAD can also be offered to selected patients.

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