Shahid Hussain Mirani, Dileep Kumar, Aqeel Ahmad
Aim: To compare the outcome of lateral sphincterotomy with anal advancement flap in patients of anal fissure.
Study design: Comparative study
Place and duration of study: Department of Surgery, Ghulam Muhammad Mahar Medical College Hospital, Sukkur from 1st January 2017 to 30th September 2020.
Methodology: Two hundred diagnosed cases with chronic anal fissure with the age range of 15yrs to 60 yrs of age of either gender were enrolled whereas those having any other perianal diseases like (hemorrhoids, fistula or abscess) or presented with acute anal fissure (less than 2 to 3 weeks) and those who had undergone previous surgical procedure in the anal canal were excluded. Group A patients underwent lateral sphincterotomy and group B patients underwent anal advancement flap procedure for chronic anal fissure. The wound infection was assessed on 3rd post-operative day of treatment and anal incontinence was assessed after 3 months of treatment.
Results: Comparison of outcome of lateral sphincterotomy with anal advancement flap in patients of anal fissure shows that 12(12%) in A Group and 4(4%) in B Group had infection (p=0.01) while anal incontinence was recorded as 17(17%) in A Group and 2(2%) in B Group (p=0.001).
Conclusion: Treatment of chronic anal fissure is better with anal advancement flap as compared to those with lateral sphincterotomy for anal continence and infection.
Keywords: Anal fissure, Lateral sphincterotomy, Anal advancement flap, Outcome