38. Recurrence Rate of Anal Fissure after Lateral Sphincterotomy at Tertiary Care Center
Habib ur Rehman Khan Toor, Gulshan Ali Memon and Qamar Raza Brohi
ABSTRACT
Objective:To determine the recurrence rate of Anal Fissure after Lateral Sphincterotomy Study Design:Observational / descriptive study
Place and Duration of Study: This study was conducted at Peoples University of Medical and Health Sciences for Women, Nawabshah from September 2011 to 2014.
Materials and Methods:Cases with anal fissures, refractory to nonsurgical conservative treatment, were selected. Cases with other associated anorectal disorders like hemorrhoids, fistulae in ano, anorectal abscess and rectal prolapse were excluded from the study. Patients with co-morbid diseases like chronic liver disease, renal failure and cardiac failure were not considered for this study. Diagnosis was solely made on history and clinical examination. All selected cases were hospitalized and underwent lateral sphincterotomy under spinal anesthesia. After 24 hours patients were discharged from hospital after 24 hours with scheduled follow up visits and post operative complications were recorded up to two years.
Results: 140 cases were selected. Mean age was 35 years SD± 7 and range of 17- 62. Male to Female ratio was almost 1:1. As a presenting symptom, pain was present in all 140 cases while bleeding was present in 82 cases. Anterior fissure was present in 17(12.2%) cases while posterior fissure was present in 123(87.8%) cases. On follow up local infection was found in 3 (2.1%) cases. There was no any case of post operative fecal incontinence but 6(4.2%) cases had incontinence of flatus. After 2 years of surgery recurrent anal fissure was noted in only in 2(1.4%) cases.
Conclusion:The very low recurrence after lateral sphincterotomy for anal fissure strongly advocates the role of lateral sphincterotomy as the ultimate gold standard procedure, especially for the refractory cases. Key Words; Anal fissure. Lateral sphincterotomy. Recurrence after lateral sphincterotomy.
Citation of article:Toor HRK, Memon GA. BrohiQR.Recurrence Rate of Anal Fissure after Lateral Sphincterotomy at Tertiary Care Center.Med Forum 2017;28(5):156-159.