Shafiq Ullah, Muhammad Nadeem.
Closed versus open lateral internal sphincterotomy in chronic anal fissure: a comparative study of postoperative complications & results.
Pak J Med Res Jan ;43(1):1-4.

In present study, patients of anal fissure admitted to surgical units of Nishtar Hospital, Multan were treated by lateral internal sphincterotomy by open and closed methods. The patients were followed up for a period of 6 months after surgery. The results of treatment were evaluated with reference to postoperative complications. Out of the 100 patients included in the study, 50 patients underwent open lateral internal sphincterotomy and the other 50 were subjected to closed lateral internal sphincterotomy. There was no significant difference in postoperative acute complications. However, incontinence in terms of soiling and passage of flatus was 30% in open method and 20% in closed method. There was no difference in terms of recurrence rate being 10% both in open and closed methods. Hospital stay was less in closed method. Healing rate was nearly equal in both procedures. Keeping in view these findings, it is recommended that chronic fissure should be treated by closed method, if the surgeon is experienced.

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