A Comparative Study between Lateral Sphincterotomy and Diltiazem Application for Anal Fissure Regarding Pain, Bleeding and Healing
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Introduction: Anal fissures are considered one of the commonest causes of severe anal pain. An anal Fissure (synonym: fissure-in-ano) is a longitudinal split in the anoderm of the distal anal canal which extends from the anal verge proximally towards, but not beyond, the dentate line. Materials and methods Prospective Longitudinal Comparative Study including Patients with anal fissure coming to the outpatient department in Tertiary Care Teaching Hospital during the period of september 2014 to November 2016. Sample size: 80 patients( 40 each group) Inclusion criteria: 1) Patients with pain during defecation 2) Patients with frank bleeding during defecation 3) Patients with skin tags { sentinel pile} Exclusion criteria: 1) Patients with signs of haemorrhoids 2) Patients with signs suggestive of fistula 3) Fungating mass or advanced malignancy of anal canal. 4) Patients with rectal prolapsed, fissures secondary to specific diseases like Tuberculosis, Crohn’s disease etc., and pregnant women. Results: Data From Tertiary Care teaching Hospital Taken and analysed to attain conclusion 40 patients were taken in each group and characteristics of age group, better pain relief hospital stay etc were compared between both the groups. In this study 80 patients were taken, they were divided into 2 groups 40 each. Group 1 were treated with 2% diltiazem gel for twice daily topical application and group 2 underwent lateral spinchterotomy. There were 15 males and 25 females with a male to female ratio of 1:1.6 in group 1 where as in group 2 males are 17 and females are 23 giving the male:female ratio 1:1.35. The study showed that most (42.5%) of the patients were in the age group of 31-40 years in group 1 which included 15% males and 27.5% females in the group. 32.5% of patients were in the 21-30 years age group, 15% in 41-50 years age group and 2.5% in 11-20 years ,5% in 51-60 years age groups,and 2.5% in >60 years. Interpretation And Conclusion: The current study shows results in favor of 2% diltiazem gel local therapy with a healing rate of 92.5% and a faster pain-relief with minimal complications. However, LIS is effective in the treatment of recurrent/ not responding to medical treatment fissure-in-ano . Though there is latency in the clearance of symptoms and lesions when compared to surgical sphincterotomy, this has shown minimal and insignificant adverse effect profile
Authors and Affiliations
Dr Gosala Rajani Devi, Dr Ch V V Siva Kumar
Keywords
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- EP ID EP244468
- DOI 10.9790/0853-1610110114
- Views 69
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