Comparison of Botulinum Toxin Injection and Lateral Internal Sphincterotomy for the Treatment of Chronic Anal Fissure

Abstract

Although the healing rate of chronic anal fissure is considerably high with botulinum toxin injection with earlier recovery and less complications compared with sphincterotomy, it occasionally requires a repeat injection, and the healing is slower. The early (two months) and late (one year) healing rates are significantly higher in the sphincterotomy group, the two groups reaching similar healing rates only at six months.

Comparison of Lateral Internal Sphincterotomy with Topical Nitroglycerine Treatment in Patients with Chronic Anal Fissure: A Prospective Randomised Study

“…In the treatment of Chronic Anal Fissure, LIS has a high success rate as high as 95%. However, the rate of incontinence after LIS varies between 0%-50% [10]. This rate changes depending on operation technique and type and duration of postoperative follow up [11].…”

Anal fissure

“…However, it has more complications in some but not all studies. [18][19][20] In recent years there has been growing interest in spinchter-sparring surgical techniques, predominantly that of fissurectomy either alone or in combination with other techniques (e.g. botulinum toxin injection or advancement flap).…”

Medical and Surgical Management of Anal Fissure - A Prospective Study

“…Richard et al shows healing rates of sphincterotomy range from 92% to 100% with majority of fissures healing within 2 months, which is similar to our result. [4][5][6][7][8][9][10][11][12][13] There was no incidence of incontinence for both flatus and faeces in both surgery groups. Haematoma was seen in 5 patients (1.2%) who underwent closed technique of LIS.…”