DOI: 10.36347/sjams.2016.v04i03.053

Pages: 904-908

The objective is to compare the result of partial Lateral Internal Sphincterotomy (LIS) and manual dilation of the Anus (MDA) in the treatment of chronic fissure-in-Ano. The material and methods were fifty patients who were randomized to two groups underwent LIS or MDA. The results of these procedure where compare in terms of operating time, difference in effectiveness, duration of hospital Stay, post operative complications and cost effectiveness. In Results During follow up period of 6 months post operatively, 24 patients LIS group and all 25 patients in MDA group had complete healing of anal fissure. The post-operative improvement in pain, bleeding and constipation did not differ significantly between the two groups. In LIS group nearly 50% patients were operated under local anaesthesia and no patient in MDA group was operated under local anaesthesia. Operative time in MDA group was significantly longer that the operative time in LIS group. In LIS group 100% patient were mobilized within 24 hours but in MDA group no patient was ambulated within 24 hours. Anal in continence of flatus and feaces were absent in LIS group and was present 16% cases in MDA group. In Conclusion our opinion, Lateral internal anal sphincterotomy should be procedure of choice for chronic anal fissure because it relieves symptoms and heal the fissure in nearly all patients. The advantages are good symptomatic relief, high rate of healing and good patient satisfaction. It has very few complication and negligible rate of recurrence and incontinence.