Introduction: Anal fissures are a common problem with widespread presence in young adults and middle-aged people. After the failure of the conservative method, there is a need for a good surgical procedure. The aim of this study is to determine the better surgical outcome between LIS and AD.
Material and methods: This is a prospective observational hospital-based study that included 65 patients with CAF in each LIS and AD group. They were followed for 3 months post-op for recurrence, pain relief, and ulcer healing. The study was conducted after approval from the ethics committee.
Result: By the end of the 2nd week, 99% of patients in the LIS group showed pain relief with a median VAS score of 1 and an IQR of 0–1, while 93.84% of patients in the AD group had a median VAS score of 1 and an IQR of 0-2. (p-value=0.013). At one month post-op 100% of patients in the LIS group show healing of ulcers, while to 92.3% in the AD group. (p-value=0.068). At the 3rd month, the LIS group shows 4.6% recurrence, while it is 27.7% in AD group, which is significantly higher with a p-value>0.001.
Conclusion: Both surgical procedures are good for ulcer healing and pain relief, but LIS shows significantly higher pain relief than AD. In terms of recurrence, LIS is a significantly better procedure than AD. Overall, LIS is a superior procedure for CAF to AD.
Key words: CAF: chronic anal fissure, AD: anal dilatation, LIS: lateral internal sphincterotomy.
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