ABSTRACT
Background: Chronic anal fissures are common disorders in Egypt. Many lines of treatment were found but the surgical one location sphinectrotomy is the standard option. The purpose of this study was to compare bilateral and unilateral internal sphincterotomies.
Patients and methods: One hundred and twenty-eight chronic anal fissure cases were studied in the General Surgery Department, Faculty of Medicine, Al-Azhar University (New Damietta). Randomized into 2 groups (A) bilateral, group (B) unilateral sphinectrotomy. All patients had a thorough history-taking process, as well as a thorough physical examination and a series of baseline tests. All patients were then given bilateral internal sphincterotomies.
Results: The mean operative time for bilateral Lateral sphinectrotomy (LIS) was longer than unilateral (P value<0,05). Pain is decreased in group (B) with bilateral LIS. (P value<0,05). After 28 days, 65.6% of cases among bilateral LIS group and 56.25% of patients in unilateral LIS group had completely healed fissures (P-value <0.05) while significant decrease in resting anal pressure was noted at 1 month in BLIS group. There was one recurrence in unilateral LIS group.
Conclusion: In the treatment of chronic anal fissure, bilateral segmental internal sphincterotomy is a new, safe, and successful method: The likelihood of incontinence is decreased, and patients report higher levels of satisfaction with the treatment.