A NEW PATTERN OF TREATMENT OF CHRONIC ANAL FISSURE; AUDIT OF THE SURGICAL MODALITIES & THE ROLE OF PHARMACOLOGICAL SPHINCTROTOMY,ONE-YEAR FOLLOW UP.

Document Type : Original Article

Authors

1 Department of Surgery, Theodore Bilharze Research Institute, Giza, Egypt.

2 Department of Anesthesi, Theodore Bilharze Research Institute, Giza, Egypt.

Abstract

This study was carried out to find an alternative method to treat chronic anal fissure. 170 patients were recruited for 
this and four different methods of treatment were done. These methods include pharmacological sphinctrotomy using 
glycerol dintrate, the anal dilatation, the formal fissuerectomy and posterior internal sphinctrotomy and the sub cuteanous lateral internal sphinctrotomy.The four groups were analyzed and followed up (immediate, short term and long term) for one year. The analyses of the results concerning the disappearance of pain, healing of the fissure (symptom free patients) and the complications mainly incontinence and recurrence (failure of treatment) and the loss of follow up of patients. It was found that the medical sphinctrotomy is a good alternative to the surgical procedures particularly for those who were unfit for surgery. The subcutaneous lateral internal sphinctrotomy was the best treatment in short and long terms follow up concerning the better results and less complications. 

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