Outcome of Lateral Sphincterotomy in Chronic Anal Fissure: A Study of 50 Cases

Background: Lateral sphincterotomy is now the standard surgical treatment for chronic anal fissure. Aims and Objectives: To determine the outcome of closed lateral sphincterotomy in the treatment of chronic anal fissures. Materials and Methods: This was a prospective cross-sectional study was conducted in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from September 2009 to June 2010 with a view to determine the outcome of lateral sphincterotomy in the treatment of chronic anal fissures. For this purpose, 50 patients of chronic anal fissures were enrolled in this study after inclusion and exclusion criteria. Results: The age of the respondents was ranging from 23 to 60 years with the mean age of 39.140 ± 8.767 years. Fifty-two percent patients were male and 48.0% were female with the male to female ratio of 1.08:1. The duration of symptoms of the respondents was ranging from 1 to 13 years with the mean 5.920 ± 3.875 years. The mean pain score was decreased from 5.32 at baseline to 0.04 at 6 weeks (p<0.001), and 96.0% of patients were pain free at 6 weeks of follow up. Complete healing was occurred in 76.0% at 2nd week, 86.0% at 4th week and 90.0% at 6th week lateral sphincterotomy. Early postoperative complication such as superficial wound infection was in 6.0% and minor incontinence in 8.0% patients. Of the minor incontinence, 6.0% had incontinence of flatus and 2.0% had incontinence of liquid but at 6th week only incontinence of flatus was present in 4.0% of patients. At the end of 6 weeks follow up period, satisfactory outcome was found in 45 (90.0%) and unsatisfactory outcome was found in 10.0% of patients. Conclusion: Lateral sphincterotomy is a standard surgical treatment for chronic anal fissure with high success rate and patients’ satisfaction with low postoperative complication.