A comparative study of the outcome of unilateral versus bilateral internal anal sphincterotomy in treatment of chronic anal fissure

Authors

  • Partha Pratim Mandal Associate Professor, Department of General Surgery, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India https://orcid.org/0009-0001-9518-533X
  • Shivaji Mandal Associate Professor, Department of General Surgery, Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India https://orcid.org/0009-0008-0879-557X
  • Debayan Chowdhury Assistant Professor, Department of General Surgery, Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India https://orcid.org/0009-0005-8778-7137

DOI:

https://doi.org/10.3126/ajms.v15i9.65960

Keywords:

Unilateral internal anal sphincterotomy; Bilateral internal anal sphincterotomy; Lateral internal anal sphincterotomy

Abstract

Background: Gold standard treatment for chronic anal fissure is lateral internal sphincterotomy. Bilateral internal sphincterotomy (BIS) as a treatment option for chronic anal fissure has not been evaluated.

Aims and Objectives: The aims and objectives of the study are to compare the efficacy of unilateral versus bilateral internal anal sphincterotomy in treatment of chronic anal fissure.

Materials and Methods: Study design: A prospective randomized comparative study. Study area: Patients coming to General Surgery outpatient department at College of Medicine and Sagore Dutta Hospital with chronic anal fissure. Study period: July 2022 to December 2023 (18 months). Sample Size: 100 patients. Study Group: Group A=Patients who had undergone unilateral internal sphincterotomy (UIS)=50 patients and Group B=Patients who had undergone BIS=50 patients.

Results: 2 (4%) patients in Group A and 3 (6%) patients in Group B developed incontinence for flatus postoperatively. No patients in either group developed incontinence for stools. The Mean Fissure Healing Time (Mean±SD) (Weeks) post-sphincterotomy was 4.32±0.91339 in Group A and 2.66±0.65807 in Group B. There were 6 cases of recurrence in the unilateral sphincterotomy group. Second surgery was needed in 4 patients who underwent unilateral sphincterotomy.

Conclusion: As compared to UIS, BIS results in a faster healing of chronic anal fissure, with no increase in incontinence, decreased pain score, and less recurrence rates.

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Published

2024-08-06

How to Cite

Partha Pratim Mandal, Shivaji Mandal, & Chowdhury, D. (2024). A comparative study of the outcome of unilateral versus bilateral internal anal sphincterotomy in treatment of chronic anal fissure. Asian Journal of Medical Sciences, 15(9), 188–192. https://doi.org/10.3126/ajms.v15i9.65960

Issue

Vol. 15 No. 9 (2024)

Section

Original Articles

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