Aftab Ahmad Baig, Muhammad Shahid Mehmood, Ashfaq Ahmad.
Close Lateral Internal Sphincterotomy, an Effective Treatment for Chronic Anal Fissure.
Pak J Med Health Sci Jan ;13(2):276-8.

Aim: To determine the close lateral internal sphincterotomy is an effective treatment for chronic anal fissure. Study Design: Quasi experimental Methods: The study was conducted at Surgical Unit I, Akhtar Saeed Trust Hospital Lahore, Pakistan from August 2017 to March 2019. Total 120 patients with chronic anal fissure , fulfilling the inclusion criteria , were selected. Close lateral internal sphincterotomy was done in all patients. Results were obtained and analyzed using SPSS version 15. Results: Out of 12 0 patients , male and female patients were 8 4(70%) and 36(30%). Age was ranging from 20 to 65 years with mean age of 38.53 and symptoms duration more than 6 months. Among symptoms anal pain was present in all patients and constipation in 106 (88.3%). On examination posterior midline anal fissure was present in 106 (88.3%) patients and anterior midline in 10(8.3%) patients while 4(3.2%) patients had both anterior and posterior midline fissure. Sentinel skin tag was present in 26 (21.7%) patients. After surgery 68.3% patients had adequate pain relief within 24 hours. Complete fissure healing was found in 96.7% of patients at 6 weeks. Wound infection 2 cases and flatus incontinence was noted in 3.3% that later improved within 10 weeks. Recurrence was seen in only two patients (1.66%) after one year. Conclusion: On the basis of results in this study I found that close lateral internal sphincterotomy is an effective treatment in The management of chronic anal fissure. It heals fissure in majority of patients with very low rate of complications.

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