Comparison of surgical and chemical sphincterotomy in the management of acute anal fissures

Objective: to compare the results and outcome of chemical and surgical sphincterotomy in the management of acute anal fissure. study design: quasi experimental study. place and duration: the study was carried out in the department of surgery,sir ganga ram hospital,lahore,from 20-08-2007 to 19-08-2009. sample size: total 100 patients of acute anal fissures materials and methods: patients who gave informed consent were randomized into two groups. fifty patients in group a underwent chemical sphincterotomy and 50 patients in group b underwent surgical sphincterotomy. they were followed up for a period of 3 months and results of two treatment modalities were compared. results: surgical sphincterotomy showed early symptomatic relief within 6.08±2.83 days as compared to 9.23±7.89 days by chemical sphincterotomy. hundred percent healing rates were observed with surgical sphincterotomy as compared to 54%with chemical sphincterotomy. conclusion: surgical sphincterotomy is better than chemical sphincterotomy in the management of acute anal fissure in terms of early symptomatic relief and high healing rates. however,chemical sphincterotomy heals 54%ofpatients in out patient setting,associated with less work loss that is no hospital admission is required,so it has a definite role in the management of acute anal fissure.