scholarly journals Closed lateral Internal Sphincterotomy under local anesthesia in OPD in the treatment of chronic Anal Fissure

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Naved Ahmad ◽  
Muzaffar Aziz ◽  
Faizullah .
Keyword(s):  
Postoperative Complications ◽  
Anal Fissure ◽  
Local Anesthesia ◽  
Local Anaesthesia ◽  
Chronic Anal Fissure ◽  
Dentate Line ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Operative Complications

Objective of this study is to provide best therapy in terms of hospital stay and post operative complications after closed lateral internal sphincterotomy under local anaesthesia in the treatment of chronic anal fissure. It is descriptive type of study carried out at Nishtar Hospital Multan, from February 2001 to April 2001. Thirty patients underwent closed lateral internal sphicterotomy in local anaesthesia in OPD. Internal anal sphincter divided up to dentate line by introducing no.11 surgical blade in the intersphicteric groove. Pts were allowed to go home just after the surgery. Follow up for complications was done for the period of 6months. Mean postoperative stay was for 12 minutes. Postoperative complications were soiling (6.6%), incontinence to flatus (3.3%) and recurrence (3.3%). CLIS can be done safely under local anesthesia in OPD with low complication rate and less postop period of stay.

scholarly journals Open lateral internal sphincterotomy safe option for chronic anal fissure. A clinical study

2021 ◽  
Vol 28 (02) ◽  
pp. 137-140
Author(s):  
Muhammad Bilal ◽  
Viqar Aslam ◽  
Waqas Jan ◽  
Zaheer
Keyword(s):  
Clinical Study ◽  
Postoperative Complications ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Local Data ◽  
Chi Square ◽  
Internal Sphincterotomy ◽  
Chi Square Test

Objectives: To provide local data regarding the postoperative complications, pain, anal incontinence and recurrence after lateral internal sphincterotomy for chronic anal fissure. Study Design: Clinical Study. Setting: DHQ Charsadda. Period: May 2017 to December 2019. Material & Methods: It was done on 230 chronic anal fissure patients who had underwent prior conservative treatment. Surgery for all patients was carried out under General anaesthesia with open sphincterotomy. Postoperative follow up was carried till 6 months. Data were collected and analysis by using SPSS version 23. Chi square test was used to compare at level of significance <0.005. Results: Mean age of patients was 37.50 ± 7.28 years. Female presented with more postoperative complications than male but differences were statistically not significant. At the end of 6th months follow up period we observed that significantly higher numbers of patients were satisfied (91.4%) with a healing rate of (93.8%). Conclusion:  LIS is treatment of choice for chronic anal fissure.

Topical 0.5% nifedipine vs. lateral internal sphincterotomy for the treatment of chronic anal fissure: long-term follow-up

2005 ◽  
Vol 21 (2) ◽  
pp. 179-183 ◽  
Author(s):  
Panagiotis Katsinelos ◽  
Basilios Papaziogas ◽  
Ioannis Koutelidakis ◽  
George Paroutoglou ◽  
Stavros Dimiropoulos ◽  
...  
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Long Term Follow Up

scholarly journals Comparative study of closed versus open lateral internal sphincterotomy in the management of chronic anal fissure

2020 ◽  
Vol 7 (4) ◽  
pp. 1158
Author(s):  
Anand R. Bansal ◽  
Manish Bansal ◽  
Ankit Bhardwaj
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Anal Verge ◽  
Dentate Line ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Significant Difference ◽  
Delayed Healing ◽  
Group A ◽  
Group B

Background: Anal fissure is a painful tear in distal anal canal extending from just below the dentate line to anal verge. Patient presents with pain during or after defecation and passage of bright red blood per anus. Various studies investigating chronic anal fissures show a large variation in healing rates for different modalities. The present study was carried out to evaluate effectiveness of closed versus open lateral internal sphincterotomy in treatment of patients with chronic anal fissure.Methods: A prospective study was conducted in the Department of Surgery, Pt. B.D. Sharma PGIMS, Rohtak. Group A and group B included 20 patients each with chronic anal fissure and managed by closed and open lateral internal sphincterotomy respectively and effectiveness was evaluated with regards to fissure healing, pain reduction, recurrence and incontinence after surgical treatment.Results: The mean pain scores on visual analogue scale at end of 1 week in group A and group B was not found to be statistically significant, whereas it was found to be statistically significant at 3 week and at 6 weeks. Delayed healing was seen in 1 patient of group B, whereas no patient in group A had delayed healing or absence of healing postoperatively.Conclusions:There was a significant difference between closed and open methods of lateral internal sphincterotomy in terms of relief in post-operative pain but as a whole both techniques did not show any statistically significant difference in terms of fissure healing, postoperative complications or recurrence at 3 months.  

scholarly journals Comparative study of lateral Internal Sphincterotomy verses Topical Glyceryl Trinitrate for treatment of fissure-in-Ano

2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Ajmal Farooq ◽  
Zahid Niaz
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Improvement ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Internal Sphincterotomy ◽  
Group A ◽  
Topical Glyceryl Trinitrate ◽  
Group B

This prospective randomized interventional study was carried in one of surgical unit of Lahore General Hospital Lahore from 1st January 2002 to 30, December 2002 a total number of 100 patients with both acute and chronic anal fissure were taken and randomly divided in two groups. Group A was treated with 0.2% GTN for 6 weeks and Group B was treated with lateral internal closed Sphincterotomy a follow up after 0, 2nd, 61h weeks and even after 6 months carried out. Peak incidence of disease was observed between 30 and 40 years of age with 56 males and 44 females. 24% patients were with acute fissure and 76% with chronic fissure. In this study with 0.2% GTN overall healing rate of 66.66% for acute fissure and 63.15% for chronic anal fissure was observed. GTN was found less effective in healing the fissure but some what good for initial symptomatic improvement in its comparison 100% healing was observed with lateral internal sphincterotomy with only 10% transient incontinence for flatus. So it was concluded that lateral internal sphincterotomy is superior to GTN and is the procedure of choice for fissure in ano.

scholarly journals Results of tailored lateral sphincterotomy for chronic fissure in-ano

2019 ◽  
Vol 6 (11) ◽  
pp. 3947
Author(s):  
Ahemadi Firdous Nikhat ◽  
Mohd Zaheeruddin Ather
Keyword(s):  
Anal Fissure ◽  
Gold Standard ◽  
Chronic Anal Fissure ◽  
Internal Sphincter ◽  
Treatment Options ◽  
Lateral Internal Sphincterotomy ◽  
Fissure In Ano ◽  
Lateral Sphincterotomy ◽  
Internal Sphincterotomy

Background: Fissure-in-ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of lateral anal sphincterotomy remains the gold standard of treatment for chronic anal fissure, however it is associated with the significant rate of incontinence. This study reviews using a tailored lateral sphincterotomy by selecting the height of internal sphincter to be divided with aim of preserving more sphincter and hence reducing the incontinence rates.Methods: The study was carried out in 50 patients who were diagnosed clinically as chronic anal fissure attending Surgery department of ESIC medical college and hospital, Kalburagi over a period of 6 months from January 2019 to August 2019. Tailored left lateral internal sphincterotomy was performed in all patients. The date was recorded and analysed. Early post-operative follow-up was maintained every week for four weeks or till the fissure healed. Complications mainly incontinence rate was assessed.Results: Common age group was third and fourth decade of life. Pain (100%) was the commonest symptom. Majority of the patients (96%) had posterior fissure. Postoperatively about 97% patients had complete pain relief. Only one patient (2%) in the study reported incontinence to flatus during the first follow-up visit and had minor incontinence and other minimal complications were found.Conclusions: Tailored lateral anal internal sphincterotomy is safe and effective surgical procedure for the management for chronic anal fissure with lower rate of incontinence rate compared to gold standard lateral internal sphincterotomy.

scholarly journals Anal fissures: Open lateral internal sphincterotomy results

2015 ◽  
Vol 2 (1) ◽  
pp. 87
Author(s):  
Abdul-Wahid M Salih
Keyword(s):  
Anal Fissure ◽  
Medical Records ◽  
Recurrent Disease ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Good Patient ◽  
Patients Satisfaction ◽  
Good Patient Satisfaction

Background: Lateral Internal Sphincterotomy is the procedure of choice for chronic anal fissure because it relieves symptoms andheals the fissure in nearly all patients. However, data on its postoperative complications are limited particularly fecal incontinence.Therefore, the aim of this study is to investigate the results of this procedure in terms of recurrence rate, complications and patientsatisfaction.Methods: The medical records of 80 patients from 4 centers were collected during 20 months and evaluated retrospectively.Results: Incontinence was observed in 2 (2.5%) patients. The patients were discharged at the same day of the operation. Duringthe average follow-up of 24 months, two patients (2.5%) developed recurrent disease. In addition, patients’ satisfaction was high(95%).Conclusions: Lateral internal sphincterotomy is the procedure of choice for chronic anal fissure because it relieves symptomsand heals the fissure in nearly all patients with very low rate of complications, negligible recurrence and good patient satisfaction.

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