(Lateral Subcutaneous Sphincterotomy with Fissurectomy versus Anal Dilatation with Fissurectomy in the Treatment of Chronic anal Fissure (A Comparative Randomised Study

Abstract

In our study the main ruling criteria were about surgical site healing, fissure recurrence and patient satisfaction. These evaluating criteria were in favor of lateral internal sphincterotomy with fissurectomy procedure with significant difference in both fissure recurrence and patient satisfaction. In terms of recurrence, it depends upon many factors, mainly, good surgical practice which will lead to low resting anal pressure which is better to be guaranteed with lateral internal sphincterotomy and good control of bowel habits, which is better guaranteed by high fiber diet, ingestion of plenty of fluids and dose of laxatives. Pain was the main presenting complaint postoperatively and it was of significant difference in comparison between both groups, thus we recommend to put a strategy for better pain control, to bear in mind a second line of analgesics specially in LIS procedure.