Hameed Khan, Muhammad Imran Khan.
Lateral internal anal sphincterotomy, an experience at Khyber Teaching Hospital, Peshawar.
Pak J Surg Jan ;30(1):18-21.

Objective: To determine the outcome in terms of complications, symptoms abolition and long term recurrence. Study design: Prospective observational study. Sett ing and duration: Surgical D unit, Department of Surgery, Khyber Teaching Hospital, Peshawar from October 2012 to September 2013. Methodology: In this study 201 consecutive patients who were subjected to lateral internal sphincterotomy for chronic anal fi ssure were included. Th is was a prospective study and patients were followed up postoperatively for six months to determine the outcome in terms of complications, symptoms abolition and long term recurrence. Results: A total of 201 patients were included in the study. Th e overall mean age of patients was 35.37 ± 8.91 years. Th ere were 121 (60.2%) female patients compared to 80 (39.8%) male patients. Clinical examination revealed the most common location to be posterior which was found in 118 (58.7%) patients. Considering the therapeutic outcomes, suffi cient pain relief (measured on visual analogue scale) was achieved post operatively in 177 (88.1%) patients within 48-72 hours. Th e fissure was completely healed in 192 (95.5%) patients in 8-10 weeks postoperative follow up. Th e most common complication which occurred was bleeding which was observed in 15 (7.4%) patients. Incontinence was noticed in 6 (3%) patients. Recurrent fissure was observed in 5 (2.5%) patients. Conclusion: Lateral internal anal sphincterotomy is a safe and effective treatment option in the management of chronic anal fissures.

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