Volume 20, No. 1, 2023
Lateral Internal Anal Sphincterotomy: A Boon In The Management Of Chronic Anal Fissure, An Experience In Kashmiri Population
Aqib Amin*, Simran Shafi, Fazl Ul Haqq, Inzamam Wani, Ajaz Ahmed Rather, Shujaut Farooq, Nafees Wani
Abstract
Background: Patients having anal fissures present commonly to surgical opds. It is caused by linear tear in the anoderm distal to dentate line. Main presenting complaint in such patients is pain while defecation. Chronic anal fissures cause psychological changes in patients that lead to poor quality of life. chronic anal fissures are treated both by medical management and surgical methods. Lateral anal sphincterotomy has proved gold standard in treating CAF. Objectives: We aimed to assess outcome of lateral anal sphincterotomy, safety and efficacy in the management of chronic anal fissure. Materials Andf Methods: This study was done in a tertiary care hospital SKIMS MCH, Bemina Srinagar, Jammu and Kashmir for a period of two years 2020 to 2022. All patients above 18 years not having any other anorectal pathology were selected from opd for this procedure, who fulfill the criteria of chronic anal fissure clinically. Data of such patients in terms of age, gender, any comorbidity, complications of this procedure, satisfaction of patient were recorded. Results: Out of 80 patients 51 were males and 29 females. Most patients were in age of 35 years. Maximum number of patients have this problem over a duration of 7 to 12 weeks. Pain while defecation was chief complaints in almost all patients. Most common complication in our study was flatus incontinence, although recurrence rate of disease was negligible. The complete resolution of preoperative symptoms was 2 months. Conclusion: LIAS is quite cost effective, safe and having very least recurrence rate, and moreover is to be done as opd procedure with no hospitalization of patient.
Pages: 32-39
Keywords: Lateral internal anal sphincterotomy, chronic anal fissure, fecal incontinence, bleeding per rectum