A COMPARATIVE STUDY OF LATERAL SPHINCTEROTOMY AND SCLEROSANT INJECTION IN THE MANAGEMENT OF CHRONIC FISSURE IN ANO

B Saptha Girish, M Bharat Kumar Raju, Ravi Teja P

Abstract


BACKGROUND: In our institution, the first-line treatment in chronic anal fissures is the injection of a sclerosing agent under the fissure after local anesthesia. This study compares the effectiveness and side effects of sclerosant injection and internal sphincterotomy.

METHODS: 60 patients with a chronic fissure in ano were randomly divided into Group 1 (sclerosant) and Group 2 (lateral internal sphincterotomy) with 30 patients in each Group and prospectively studied  and compared.

RESULTS: The mean duration of healing was comparatively longer in Group 1(5.04 weeks) than Group 2 (3.6 weeks). The patients were completely free from pain in both groups. The complication rate was low (3.3%) : 1 necrosis of the skin and 1 abscess at the site of injection. On Comparison between        the two groups, did not show any difference in relief of pain  (p= 0.5261) or healing of fissure (p= 0.0679).

CONCLUSION: The injection of a sclerosing agent under the fissure is performed in the practitioner's clinic. Healing rates are high; complications and recurrences are low. This therapeutic option may be a good alternative to classical treatments in case of anal fissures.


Keywords


fissure-in-ano, sclerotherapy, setrol , lateral sphincterotomy.

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References


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