scholarly journals LATERAL INTERNAL SPHINCTEROTOMY

2011 ◽  
Vol 18 (03) ◽  
pp. 350-353
Author(s):  
SHAZIA JAHAN ◽  
MUHAMMAD ATEEQ
Keyword(s):  
Conservative Treatment ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Relief ◽  
Lateral Internal Sphincterotomy ◽  
General Surgeon ◽  
Female Population ◽  
Internal Sphincterotomy ◽  
Female Patients ◽  
History Of

Objective: To observe the prevalence of anal fissure, and outcome of open lateral internal sphincterotomy in terms of symptomatic relief, fissure healing and complications of procedure in female population. Study Design: Cross sectional, Prospective interventional. Setting & Duration: Surgical Unit DHQ (Teaching) Hospital Rawalpindi, Women Medical Complex Sialkot over a period of seven years from 2003 to 2010. Methodology: Female Patients with chronic anal fissure with history of failed conservative treatment were included in the study after taking informed consent. All patients were evaluated and managed by consultant General Surgeon and were subjected to open lateral internal sphincterotomy (LIS). Results: Two hundred and seventy three female patients of mean age of 39.5 years with chronic anal fissure and history of failed / noncompliance to conservative treatment were enrolled in this study. All patients underwent open lateral internal anal sphincterotomy. Post operatively had excellent recovery, were ambulant on same day. Minor complications were noted in 44 patients (0.16%). Moderate pain at operation site was the commonest complication seen in 32 patients (0.11%). No major complication like permanent incontinence of flatus and feces or recurrence was reported in any of the patients. Conclusions: Lateral internal sphincterotomy remains an effective treatment for chronic anal fissure in the hands of experienced surgeon with highest patient satisfaction, and should be considered as the first line therapy in chronic and resistant / recurrent acute anal fissures.

scholarly journals Lateral Internal Sphincterotomy for Treatment of Chronic anal Fissure in Paediatrics

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Surgical Technique ◽  
Conservative Treatment ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Postoperative Bleeding ◽  
Lateral Internal Sphincterotomy ◽  
Open Technique ◽  
Internal Sphincterotomy ◽  
History Of ◽  
A Prospective Study

Aims: Lateral internal sphincterotomy is a well established surgical technique for treatment of chronic anal fissure in adult. We performed this study to evaluate the outcome of lateral internal sphincterotomy in Paediatrics. Patients and Methods: This is a prospective study performed over a period of 4 years from October 2008 to October 2012 on 37 patients with chronic anal fissure of a duration exceeding 3 months and history of failure to conservative treatment. All patients underwent left lateral internal sphincterotomy through an open technique. Outcome was evaluated by assessing the effectiveness of this procedure in relieving the symptoms, fissure healing, parents’ satisfaction and complication rate. Results: There were 26 boys and 11 girls, mean age was 11 months with a range of (6 months - 12 years), and symptoms were relieved within 2 weeks in 28 cases and within one month in 5 cases. 4 patients require postoperative oral laxative for 1-3 months to overcome the withholding behavior. Fissures were healed in 34 by 8 weeks postoperatively. Parent satisfied with the outcome in 32 patients. 4 patients developed postoperative bleeding and only one of them was serious and required cauterization, soiling occurred in 3 cases. No permanent incontinence was reported. Conclusion: Lateral internal sphincterotomy is an effective and safe surgical technique for treatment of chronic anal fissure not responding to medical treatment in paediatric. Complications are uncommon and the risk of incontinence is very minimal if proper surgical technique is performed.

scholarly journals Comparative study of lateral internal sphincterotomy versus local 0.2%glyceryl trinitrate ointment for the treatment of chronic anal fissure

1970 ◽  
Vol 34 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Md. Ibrahim Siddique ◽  
Khandker Manzoor Murshed ◽  
M.A. Majid
Keyword(s):  
Glyceryl Trinitrate ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Relief ◽  
Symptom Relief ◽  
Prospective Trial ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Resting Anal Pressure ◽  
Glyceryl Trinitrate Ointment

The gold standard surgical treatment of chronic anal fissure is lateral internal sphincterotomy which lowers the resting anal pressure and effectively heals the majority of fissures. Local application of 0.2% glyceryl trinitrate ointment has been used as an agent for chemical sphincterotomy, causing temporary alleviation of sphincter spasm and allowing the fissure to heal without compromising the anal continence. The aim of the present study was to compare the results of surgical sphincterotomy with that of local 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissure. Seventy adult patients between the age of 18 and 50 years with chronic anal fissure were randomized in a prospective trial to receive either surgical sphincterotomy or 0.2% glyceryl trinitrate ointment locally. Patients were followed up at 2 weeks’ interval for 10 weeks. Symptom relief, fissure healing and continence scores were the outcomes assessed. Six patients were excluded for protocol violations. Surgical sphincterotomy was significantly more effective in providing pain relief and was associated with significantly better fissure healing rates at 6 weeks and 10 weeks (both p0.05). Considering early symptomatic relief, rapid fissure healing and better patient compliance surgical sphincterotomy is the treatment of choice for chronic anal fissure.Keywords: Anal fissure; Glyceryl trinitrate; SphincterotomyDOI: 10.3329/bmrcb.v34i1.1163Bangladesh Med Res Counc Bull 2008; 34: 12-15

scholarly journals Comparative evaluation of fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure

2018 ◽  
Vol 5 (4) ◽  
pp. 1407
Author(s):  
A. R. Bansal ◽  
Pradeep Yadav ◽  
Suvendu Jena ◽  
Sanjeev Kumar
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Anal Fissure ◽  
Comparative Evaluation ◽  
Chronic Anal Fissure ◽  
Symptomatic Relief ◽  
Age Groups ◽  
Complete Healing ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy

Background: Anal fissure is a common anorectal condition that affecting all age groups, but it is seen in young and healthy adults with equal incidence across both the sexes. The objective of this study was to evaluate and prospectively compare fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure in terms of symptomatic relief, healing, recurrence and incontinence, if any.Methods: 50 patients with chronic anal fissure were alternately divided in two groups. In one group fissurectomy was done and in another group, patients underwent lateral internal sphincterotomy and comparative evaluation was done.Results: Complete healing was observed in 92% patients in fissurectomy group and 96% patients in lateral internal sphincterotomy group at the end of 6 weeks. Fissurectomy group patients reported early cut through of sutures and infection whereas in lateral internal sphincterotomy group two patients developed perianal hematoma at 3 months of follow up.Conclusions: While considering surgical management for treating chronic anal fissure, fissurectomy is comparable to lateral internal sphincterotomy in terms of symptomatic pain relief, healing rates with minimal side effects and low recurrence.

Clinical Outcomes of Lateral Internal Sphincterotomy for Patients with Chronic Anal Fissure

2007 ◽  
Vol 23 (5) ◽  
pp. 292
Author(s):  
Jung Soo Park ◽  
Jae Bum Lee ◽  
Tae Sun Kim ◽  
Hang Jun Cho ◽  
Do Sun Kim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy

Calibrated lateral internal sphincterotomy for chronic anal fissure

2005 ◽  
Vol 9 (2) ◽  
pp. 127-132 ◽  
Author(s):  
G. Rosa ◽  
P. Lolli ◽  
D. Piccinelli ◽  
F. Mazzola ◽  
C. Zugni ◽  
...  
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy

scholarly journals CHRONIC ANAL FISSURE

2011 ◽  
Vol 18 (04) ◽  
pp. 562-565
Author(s):  
ABID HUSSAIN ◽  
KISHWAR NAHEED
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Medical Center ◽  
Anal Verge ◽  
Symptomatic Relief ◽  
First Line ◽  
Detailed History ◽  
History Of ◽  
First Line Treatment

Objective: To determine the role of chemical syphincterotomy as non surgical management of chronic anal fissure. Study Design: Descriptive. Setting: This study was conducted at Margalla teaching Hospital and United Medical center .Rawalpndi. Period: 1½ years. Patients & Methods: This study included 70 patients of either sex. A personal bio data and detailed history of dietary and bowel habits were registered. Topical 0.2% GTN (Gylciryltrinitrate) was applied to anal verge 2 times per day for the period of two months and its effects were noted. Result: 58 patients (83%) got symptomatic relief and 12 patients (17%) did not get improvement. Conclusions: Chemical syphincterotomy heals majority of the fissure . Topical 0.2% GNT ointment is widely used as a first line treatment in U.K . It is generally accepted as an effective treatment for chronic fissure .

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 A Comparison between the Results of Open versus Closed Lateral Internal Sphincterotomy in the Surgical Management of Chronic Anal Fissure

2018 ◽  
Vol 8 (3) ◽  
pp. 235-239
Author(s):  
Md Mahabub ◽  
Md Mahbubur Rahman ◽  
Md Tanvirul Islam ◽  
Selina Sultana
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Lateral Internal Sphincterotomy ◽  
Complication Rates ◽  
Open Technique ◽  
Female Ratio ◽  
Internal Sphincterotomy ◽  
Closed Technique ◽  
Increased Risk ◽  
Open Versus

Background: Lateral internal sphincterotomy is regarded as the gold standard surgical treatment for chronic anal fissure. Some authors reported that the closed technique had lower complication rates than that by the open technique, but others reported that both of the techniques had no meaningful differences in complications.Methods: This was a comparative and cohort study carried out at Department of Colorectal Surgery, Combined Military Hospital (CMH) Dhaka, Bangladesh, from October 2013 to October 2017. Eighty three patients with chronic anal fissure not responding to medical treatment for at least three months were included in this study to compare the results of the open versus closed techniques of lateral internal sphincterotomy after four months follow up postoperatively.Results: The mean age at presentation was 34.15±11.4 years and the male to female ratio was 1.24:1. The results of open and closed techniques were compared regarding per-operative bleeding (35.71% versus 12.19%), post-operative urinary retention (4.76% versus 0%), symptom relief on first post-operative day (76.19% versus 70.73%), significant 1st post-operative day pain in the operated wound (33.33% versus 7.31%), temporary fecal soiling (2.38% versus 0%), temporary flatus incontinence (7.14% versus 0%), and fissure recurrence (0% versus 14.63%) respectively. Temporary incontinence to fecal and flatus recovered by conservative management within two and four months of surgery respectively.Conclusion: The closed technique of lateral internal sphincterotomy had lower post-operative complications, pain, bleeding, and incontinence compared to open technique, but increased risk of fissure recurrence.Birdem Med J 2018; 8(3): 235-239

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