क्लिनिकल गैस्ट्रोएंटरोलॉजी जर्नल

Retrospective Analysis of Lsias Verses Pharmacological Management in Acute Anal Fissure; A Study in Zonal Service Hospital

Abstract

Jani B and Nagar HS

Background: Acute anal fissure is a quiet common and extremely painful condition of anal canal. The prevalence of anal fissures has changed due to change in food habits in the Indian subcontinent. Medical management is a recent trend in the treatment of anal fissure however the parameters for measurement of outcome are result based and not measuring quality of life post treatment. Here we have conducted a randomised retrospective study of our patients which were managed by various medical and lateral subcutaneous internal sphincterotomy. The results of study were documented and studied in retrospectively. The results were analysed on various parameters of symptomatic relief of pain, after different period of time, and improved comfort during and after treatment. It was also studied the incident of anal fissure in males and females. Recent studies and clinical work is advocating medical management of acute anal fissure citing reasons of early recovery and avoiding unnecessary admissions. However it seems a very short sighted development because either the cases which had recurrence may not have reported back or it is a too quick fix solution without considering long term implications.

Aims and Objectives: The aim of study was to evaluate role of Lateral Subcutaneous Internal Anal Sphincterotomy (LSIAS) vis-a-vis conservative management in cases of Acute anal fissure in terms of clinical parameters.

Material and Methods: It is a retrospective analysis of results of randomly selected patients in a service hospital surgical OPD and In-patient cases. Patients were administered treatment randomly and results were analysed at the time of discharge. Data of only those patients were used who could be followed up for next 6 months.

Results: In our clinical study it was found that surgical intervention in the initial and first encounter has better overall response as compared to conservative management over a period of time.