Variation in Clinical, Manometric and Endosonographic Findings in Anterior Chronic Anal Fissure: A Prospective Study

Background: Chronic anal fissure is a familiar entity in surgical outdoor departments of hospitals in our valley. The muslim women are usually reluctant to expose their anal canal related pathologies to male surgeons, letting anal fissures to reach the chronic stage. Under this background, the present study was conducted to look for the feasibility of lateral anal sphincterotomy in the management of chronic anal fissure in our patients.Methods: This prospective study was carried out over a period of 3 years in the unit 2nd of department of surgery at SMHS (Shri Maharaja Harisingh) hospital, an associated hospital of Government Medical College Srinagar. During this period, 59 patients presented to the outpatient department with typical chronic anal fissures and were included in this study.Results: Fifty-nine patients, diagnosed on clinical evaluation as chronic anal fissure were included in this study. The age varied from 19 to 58 years with mean age of 36.38±7.14 (SD= 7.14) years. There was a female predominance, with a female to male ratio of 2.1:1. Fifty-two (88.1%) patients had posterior midline fissure and 7 (11.8%) patients had an anterior anal fissure. Thirty-one patients were not satisfied with the conservative treatment and insisted for surgical management. All 31 patients were managed by open lateral anal sphincterotomy.Conclusions: Lateral anal sphincterotomy (LAS) is a safe and effective method of management for chronic refractory anal fissures. The complications are minimal and negligible.

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Long-Term Results of “Chemical Sphincterotomy” for Chronic Anal Fissure: A Prospective Study

Diseases of the Colon & Rectum ◽

10.1007/s10350-006-0510-9 ◽

2006 ◽

Vol 49 (6) ◽

pp. 858-864 ◽

Cited By ~ 27

Author(s):

Joseph Lysy ◽

Eran Israeli ◽

Sharon Levy ◽

Gloria Rozentzweig ◽

Nourit Strauss-Liviatan ◽

...

Keyword(s):

Prospective Study ◽

Anal Fissure ◽

Chronic Anal Fissure ◽

Long Term Results ◽

Chemical Sphincterotomy ◽

A Prospective Study

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Subcutaneous internal lateral sphincterotomy (SILS) versus nitroglycerine ointment in anal fissure: A prospective study

International Journal of Surgery ◽

10.1016/j.ijsu.2010.01.013 ◽

2010 ◽

Vol 8 (3) ◽

pp. 248-251 ◽

Cited By ~ 4

Author(s):

Shiraz Ahmad Rather ◽

Tanveer Iqbal Dar ◽

Aijaz Ahmad Malik ◽

Aijaz Ahmad Rather ◽

Asima Khan ◽

...

Keyword(s):

Prospective Study ◽

Anal Fissure ◽

Lateral Sphincterotomy ◽

A Prospective Study

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Effectiveness and Complications of 0.2% Glyceryl Trinitrate in the Treatment of Chronic Anal Fissure

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v25i1.167 ◽

1970 ◽

Vol 25 (1) ◽

pp. 14-17 ◽

Cited By ~ 1

Author(s):

KM Murshed ◽

MI Siddique ◽

MA Rahman

Keyword(s):

Side Effects ◽

Pain Relief ◽

Glyceryl Trinitrate ◽

Anal Fissure ◽

Chronic Anal Fissure ◽

Symptom Relief ◽

Major Side Effect ◽

Primary Focus ◽

A Prospective Study

Background: The aim of this study was to analyze the effectiveness and morbidity of chemical sphincterotomy by 0.2% glyceryl trinitrate (GTN) in the treatment of chronic anal fissure. The main end points were symptom relief, fissure healing and side effects. Methods: A prospective study was conducted to see the effectiveness and side effects of 0.2% glyceryl trinitrate in the treatment of patients with chronic anal fissure attending the outpatient department of surgery from February 2004 to the end of February 2005. All the patients were followed up at 2 weeks interval for 8 weeks. The primary focus was fissure healing and the secondary focus were on improvement of symptoms, need for surgical sphincterotomy and side effects. Results: One hundred and twenty two adult patients, both male and female with chronic anal fissure were treated with local application of 0.2% glyceryl trinitrate. Pain relief occurred earlier than fissure healing. At the end of 8 weeks treatment about two third of the total patients got complete pain relief and fissure healing. Headache was the major side effect. Conclusion: Topical application of 0.2% glyceryl trinitrate (GTN) should be the initial treatment of choice for chronic anal fissure to avoid the long term complication of incontinence following surgical sphincterotomy. (J Bangladesh Coll Phys Surg 2007; 25 : 14-17)

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