A clinical study on the management of chronic anal fissure

Abstract

Background: Fissure in ano is one of the most common benign anorectal disorder encountered in surgical practice causing considerable morbidity to the patient.This study is an attempt to clinical evaluation of chronic anal fissureand evaluation of different modalities of treatment which includes conservative management and surgical management. Methods: This is a prospective cohort study conducted in department of general surgery, government general hospital,Ongole conducted during period of October2018 to September 2020.A totalof 180 patients who met the inclusion criteria were categorized into conservative management using 2% Diltiazem ointment and surgical management of either manual anal dilatation and lateral internal sphincterotomy. All patients were analyzed in terms of healing of fissure and relief of symptoms, post op complications, hospital stay, recurrence were studied. Results: 85 patients were randomized to conservative management. Out of 85 patients 60 patients got symptomatic relief and 25 patients had recurrence of symptoms. 2% diltiazem ointment has asuccess rate of 76% at the end of 6weeks.Side effects are minimal.Lateral internal sphincterotomy is the most efficient surgical procedure for chronic anal fissure which is associated with 96% success rate and associated with less complications when compared to manual anal dilatation.