EFFICIENCY OF LATERAL INTERNAL ANAL SPHINCTEROTOMY BY CLOSED METHOD UNDER LOCAL ANAESTHESIA AS AN OUT PATIENT PROCEDURE

Abstract

Chronic anal fissure is one of the main proctological disorders encountered in surgical outpatient departments, due
to its high prevalence and the great discomfort involved.Though, the exact aetiology of primary anal fissure is still
unknown, high resting anal pressure caused by increased internal sphincter tone appears to be the underlying pathological factor. So, the aim of this study is to determine the efficiency of the procedure of lateral internal sphincterotomy by closed method under local anaesthesia as an outpatient procedure. The clinical study was undertaken in all
patients (70 patients, mean age 35 years) undergoing lateral closed sphincterotomy for chronic anal fissure (defined
as anal fissure with > 6 weeks symptoms duration) from June 2005 to May 2006 who presented to Surgical OPD,
in our hospital. Among 70 studied patients, 41 (58.5%) were females and 29 (41.4%) males. Age ranged from 16-63
years with the mean age of 35 years. Post-operatively, early complications included minor bleeding in two patients
(3.4%) and incontinence of flatus in five patients (8.6%). In all the patients in our study lateral internal sphincterotomy was performed under local anesthesia and they were followed up for 4 months. 88% of patients were cured of
their symptoms while only in 12% the fissure failed to heal. Lateral internal anal sphincterotomy by closed method
under local anesthesia as an outpatient procedure has very good results in patients with chronic anal fissure who do
not respond to conservative treatment.