EFFICACY OF LATERAL INTERNAL SPHINCTEROTOMY VERSUS TOPICAL 0.2% GLYCERYL TRINITRATE OINTMENT IN THE TREATMENT OF CHRONIC ANAL FISSURE

Abstract

Objective: To compare the efficacy of lateral internal sphincterotomy (LIS) and topical 0.2% glyceryl trinitrate (GTN) ointment in the treatment of chronic anal fissures.

Methodology: This trial was conducted at the Department of Surgery, Mercy Teaching Hospital, Peshawar Medical College, Peshawar. One hundred patients with chronic anal fissure were randomly allocated to two groups. Group A patients were treated with LIS and Group B with GTN. Pain during defecation was assessed using the Visual Analog Scale (VAS) at 2 and 6 weeks of follow-up between both groups.

Results: At the 2-week follow-up we found that 90% patients in the LIS group showed notable efficacy in pain relief when compared to 44% in the GTN group (p=0.0001). At six weeks the efficacy in LIS group was 98% while 58% in the GTN group (p=0.0001).

Conclusion: Lateral internal sphincterotomy (LIS) is notably more effective than topical 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissures.