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Article Type

Original Study

Abstract

Objectives The objective of this study was to evaluate and compare the effectiveness of lateral internal sphincterotomy (LIS, an alternative approach) versus fissurectomy in the surgical management of chronic idiopathic anal fissure. Background LIS (an alternative approach) versus fissurectomy in the management of chronic anal fissure is presented and its potential advantages are described. Patients and methods This is a prospective randomized study including 40 patients presenting with chronic anal fissure (>2 months). The patients were distributed randomly between two equal groups: group A underwent LIS (an alternative approach), and group B underwent fissurectomy. Both groups were evaluated for postoperative pain, postoperative fissure healing, and postoperative complications. Results All patients in group A were pain-free and without bleeding within 1 week, whereas 65% in group B were pain-free in the same period. Urinary retention was noted in one patient (5%) in group A, whereas it was noted in two patients (10%) in group B. Incontinence to flatus was noted in two patients (10%) in group A, whereas it was noted in three patients (15%) in group B. There was one patient (5%) with fissure recurrence in group B but none in the LIS group. No patient in either group was affected with anal stenosis or perianal infections. All wounds healed within 4 weeks in group A, whereas 85% healed within the same period in group B. Conclusion In the surgical treatment of chronic anal fissure not responding to conservative management, LIS may be the better treatment and, perhaps, the preferable surgical technique with fewer total complications (P < 0.005).

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