Subcutaneous internal lateral sphincterotomy (SILS) versus nitroglycerine ointment in anal fissure: A prospective study

Abstract

Subcutaneous internal lateral sphincterotomy under local anesthesia is more curative, easy and safe, in the hands of a beginner as well as an experienced surgeon, with highest patient satisfaction, and should be considered as the first line of therapy in both chronic and resistant/recurrent acute anal fissures.

A comparison of segmental internal sphincterotomy versus lateral internal sphincterotomy in management of chronic fissure in ano

“…Male to female ratio was practically equal 1.07:1 suggesting the equal distribution of gender in patients suffering from chronic fissure in ano. 2,6,9,12 These findings are quite consistent with the studies in the literature except a study from Egypt, where there was a male preponderance the reason for which was females were reluctant to show to male surgeons, hence male dominated the study. 11 Pain on defecation was the chief presenting complaint in all patients of the present study, which is quite consistent with the reported studies from Egypt, United Kingdom, Canada and India.…”

“…1 The cause of fissure in ano remain to be defined but expected view is a combined effect of constipation (hard stools), internal anal sphincter hypertonia and certain predisposing factors like smoking, alcohol consumption of high fat diet, non-vegetarian diet etc. [2][3][4] Medical management is the first line of treatment in all fissure in ano which aims to regulate the bowel movements by high fiber diet, stool softener, osmotic laxatives and topical medications which consist of local anaesthetic and anti-inflammatory agent which reduces the local pain and irritation. The ideal treatment for reducing the hypertonicity of anal sphincter is debatable and it could be medical or surgical manipulation which remains the cornerstone of the treatment.…”

“…The ideal treatment for reducing the hypertonicity of anal sphincter is debatable and it could be medical or surgical manipulation which remains the cornerstone of the treatment. 2 Lateral internal sphincterotomy, remains the most effective and timetested surgical procedure for treatment of chronic fissure in ano with a fissure cure rate of 90-100%. 5 The major drawback of lateral internal sphincterotomy was the development of anal incontinence mainly to flatus.…”

“…5 The major drawback of lateral internal sphincterotomy was the development of anal incontinence mainly to flatus. 2 The present study aims to compare the newer procedure that is "segmental internal sphincterotomy" with standard "lateral internal sphincterotomy" in the Indian scenario as very few comparative studies are available.…”

Fissure-In-ANO

“…The aim of a sphincterotomy is to release tension in the IAS by dividing it and thus allowing healing [63]. In broad terms, there are two categorised subtypes: the posterior and lateral approaches.…”