EVALUATION OF “TAILORED LATERAL ANAL SPHINCTEROTOMY” FOR CHRONIC ANAL FISSURE- A PROSPECTIVE STUDY.

Abstract

Fissure in Ano is one of the most common painful anorectal conditions encountered in surgical practice. There are several effective non-surgical methodsof managing acute anal fissure.If conservative measures fail surgical option is offered to the patients. Lateral sphincterotomy is a surgical option recommended and accepted worldwide. The aim of our study was to assess tailored lateral sphincterotomy in terms of safety and final outcome for the surgical management of chronic anal fissure.

Patients and Method: Eighty-one diagnosed cases of chronic anal fissure who failed conservative management attending Mohammad Afzal Beigh Memorial Hospital (MABM) surgical OPD between September 2016 to September 2018 were enrolled in this study, titled tailored left lateral internal sphincterotomy(LLIS). The date was recorded and analysed. Post-operative follow- up was maintained every week for four visits or till the fissure healed.  Complication if any was recorded.

Results: Common age group was third and fourth decade of life. Most of the patients were females. Pain (100%) was the commonest symptom. Majority of the patients ( 91.67%) had posterior fissure. No recurrence or major faecal incontinence was reported by any patient.

Conclusion: Tailored lateral sphincterotomy is safe and effective surgical procedure for the management for chronic anal fissure with minimal postoperative complications.

Keywords: Chronic; anal fissure; lateral sphincterotomy; tailored.