38. Early Complications of Open versus Closed Internal Anal Sphincterotomy in the Management of Chronic Anal Fissure
Jabran Zafar, Fazila Hashmi, Altaf Ahmed Talpur, Ishrat Rahim Katyar, Iqra Khanzada Riaz Akhtar
ABSTRACT
Objective: This study was performed to compare the outcome of open and closed lateral internal sphincterotomy in
terms of early postoperative complications.
Study Design: Quasi-experimental study
Place and Duration of Study: This study was conducted at the Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro Pakistan from June 2017 to May 2018.
Materials and Methods: All the patients with chronic anal fissure were consented and enrolled in the study. After lateral internal anal sphincterotomy, either by open or closed technique, outcomes were recorded on a pre-approved Performa. Data regarding patient’s demographic characteristic age, gender and pain, bleeding, infection, soiling of clothes) was recorded.
Results: A total of 50 patients underwent closed anal sphincterotomy (11 males; mean age, 34.9 years) and 50 patients had open anal sphincterotomy (12 males; mean age, 27.77 years). There was a significant difference in infection rates between open and closed internal sphincterotomy (4.4% & 15.6%; p-value =0.013). The postoperative pain and bleeding were statistically insignificant in both groups (p=0.145).Postoperative hospital stay was found to be significant (p-value = <0.001) and mean shorter hospital stay in patients undergoing closed anal sphincterotomy.
Conclusion: Closed and open Lateral internal sphincterotomy is effective in the treatment of chronic anal fissure. Close internal sphincterotomy is preferable to open internal sphincterotomy because it affects a similar rate of postoperative pain, bleeding, and fewer hospital stay days.
Key Words: Anal fissure; Continence; Sphincterotomy; Closed Anal Sphincterotomy
Citation of article: Zafar J, Hashmi F, Talpur AA, Katyar IR, Khanzada I, Akhtar R. Early Complications of Open versus Closed Internal Anal Sphincterotomy in the Management of Chronic Anal Fissure. Med Forum 2021;32(1):156-158.