Lateral internal sphincterotomy versus 0.25 % isosorbide dinitrate ointment for chronic anal fissures: a prospective randomized controlled trial

Arslan, Kemal; Erenoğlu, Bülent; Doğru, Osman; Turan, Ersin; Eryılmaz, Mehmet Ali; Atay, Arif; Kokcam, S. Said

doi:10.1007/s00595-012-0326-2

Cited by 19 publications

(4 citation statements)

References 32 publications

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“…Most of these measures are effective not only for acute fissures but have a role to play in chronic fissures as well. There is however, a relatively higher recurrence rate and fissure persistence when compared to surgical management 7,8,9 . Surgical management is often offered only when a fair trial of medical management has failed.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Evaluation on the Surgical Management of Chronic Anal Fissure With Different Methods of Anaesthesia

Grover

2019

IJMBS

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Introduction: Fissure-in-Ano or Chronic Anal Fissures (CAF) is a linear ulcer in the squamous epithelium of the anus, distal to the dentate line & one of the most common and painful anorectal conditions encountered in surgical practice. Surgeons working in a rural setups and First Referral Units are faced with several challenges and limitations. Patients undergoing surgery under spinal anaesthesia have to undergo a battery of blood tests and imaging as a result for poorer patients the cost of treatment becomes manifold. This retrospective study was aimed to compare the outcome of lateral anal sphincterotomy (LAS) for chronic anal fissure, done under Spinal Anaesthesia and Local Anaesthesia. Methods: This Retrospective study involved Prior Consent from the Hospital Authorities & was found to be within ethical standards. Data of 200 patients were selected which were proven cases of Chronic Anal Fissures admitted to the local surgical units in last 4 years. Subjects included both the genders, all age groups including pediatric and geriatric age group and all classes of socio economic strata. Results: Data of total 200 patients were obtained, out of 200 participated 127 were women and 73 were men. A total of 100 patients (50%) underwent LAS under local anaesthesia and 100 patients (50%) underwent LAS under spinal anaesthesia. The mean age of the patients was 41.37 years with Standard Deviation of 3.42 years. There was No Statistical Difference between the two groups in terms of Intraoperative and Postoperative Complication like Pain, Incontinence & Infection after follow up. Conclusion: Lateral anal sphincterotomy (LAS) provides very good healing of Chronic Anal Fissure. Few distinct advantages were noted in the study while doing LAS under LA. It provides adequate pain relief for the procedure apart from the advantage of easy palpability of the sphincter. It can be done as an Outpatient procedure without the need for an anesthetist, and carries a significant cost benefit to the patient especially in lower socio-economic settings. There is no significant difference in the complications or the healing of the fissure when compared with SA. Keyword: Fissure-in-Ano , Lateral anal sphincterotomy, Spinal Anaesthesia , Local Anaesthesia , Retrospective Study.

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Section: Introductionmentioning

confidence: 99%

A Retrospective Evaluation on the Surgical Management of Chronic Anal Fissure With Different Methods of Anaesthesia

Grover

2019

IJMBS

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“…4 Surgical treatment remains to be the principal treatment for chronic resistant cases. 5 Initial experience with the posterior sphincterotomy was unsatisfactory; the main weakness of this procedure was a significant rate of recurrences and anal incontinence and a long period required for the wound to heal. 6 Many of these drawbacks were overcome by the adoption of subcutaneous lateral internal sphincterotomy (LIS).…”

Section: Introductionmentioning

confidence: 99%

Full Length versus Partial Length Lateral Internal Sphincterotomy for the Treatment of Chronic Anal Fissure

Elgohary

2017

Ain Shams Journal of Surgery

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Background and aim: Surgical treatment with lateral internal sphincterotomy (LIS) remains the principal treatment for chronic resistant cases with high degree of success despite persistence or recurrence of anal fissures. The incidence of these unfavorable outcomes has been reported to be related mostly to the height of the sphincterotomy. The aim of this study was to evaluate the effectiveness and safety of full length LIS compared to partial length LIS.Patients and methods: Between May 2008 and June 2014, we surgically treated 80 patients with chronic anal fissure. Group A had partial length LIS and group B had full length LIS. All the patients were continent preoperative and postoperative data were recorded regarding pain, bleeding, infection, recurrence and postoperative incontinence.Results: None of our patients in both groups had permanent incontinence to flatus or stools. Temporary incontinence to stool and flatus occurred in 9 patients with full length LIS group and only in 3 patients in the partial length LIS. Conclusion:Full length LIS is a safe effective procedure for the treatment of resistant chronic anal fissure.

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“…Although many studies suggest that the etiology of anal fissure has an ischemic origin and anal fissures may be healed with the reduction of anal sphincteric pressure either chemically or surgically, surgical treatment remains the principal treatment for chronic, intractable cases. Currently, among numerous other defined surgical techniques, lateral internal sphincterotomy (LIS) is the most frequently performed procedure for the treatment of anal fissures (5). Although a decrease in anal sphincteric pressure is the desired outcome of the procedure, an incompetent anal sphincter complex may result in anal incontinence.…”

Section: Introductionmentioning

confidence: 99%

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

Peker¹,

Yılmaz²,

Demiryılmaz³

et al. 2014

Turk J Med Sci

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Lateral internal sphincterotomy versus 0.25 % isosorbide dinitrate ointment for chronic anal fissures: a prospective randomized controlled trial

Abstract: ISDN ointment was reported by all patients to be easy to use. Although its success rate was lower than that of surgery, ISDN can be offered to selected patients with a chronic anal fissure, as it has a low recurrence rate and rare side effects are rare.

Cited by 19 publications

References 32 publications

A Retrospective Evaluation on the Surgical Management of Chronic Anal Fissure With Different Methods of Anaesthesia

A Retrospective Evaluation on the Surgical Management of Chronic Anal Fissure With Different Methods of Anaesthesia

Full Length versus Partial Length Lateral Internal Sphincterotomy for the Treatment of Chronic Anal Fissure

The effect of lateral internal sphincterotomy on resting anal sphincter pressures*

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