A study of effectiveness of glyceryl trinitrate ointment versus surgical management of patients with chronic anal fissures at tertiary health care centre
Journal Title: Medpulse International Journal of Surgery - Year 2019, Vol 10, Issue 3
Abstract
Background:Fissure-in-ano is one of the most common causes of anal pain. It is a linear tear in the squamous epithelial lining of anal canal distal to dentate line. Aims and Objectives: To study effectiveness of Glyceryl Trinitrate Ointment versus Surgical Management of patients with chronic anal fissures at tertiary health care centre. Methodology:This was a cross-sectional study carried out in the department of Surgery during the one year period i.e. April 2018 to April 2019 in the patients suffered from chronic anal fissures. During the one year period there were 46 patients included into the study with written and explained consent were included into the two different treatment groups i.e. Group A (Glyceryl Trinitrate Ointment)and Group B (Surgical Management)with all necessary surgical fitness protocols.The data was analyzed by unpaired t-test and chi-square testand calculated by SPSS 19 version software. Results: The most common complaints were Bleeding PR in 100.00%, followed by Pain in 91.30%, Painful Defecationin 86.96%, H/o Constipation in 76.09%, Weakness in 63.04%. Bleeding during Procedure was significantly higher in group B as compared to Group A (P< 0.0001; t =49.89, df=44); Time to first bowel movement (hr) was higher in group B as compared to Group A(P<0.001; t=9.89 df=44) and also Average Wound healing time (Days) more in group B(P<0.001;t=23.15 df=68).Postoperative pain(VAS-score) was significantly higher in Group B as compared to Group A onDay 0, Day 3, Day 6 respectively as t=5.12,df=44,p<0.05, t=4.26,df=44,p<0.05, t=5.91,df=44,p<0.05.Conclusion:It can be concluded from our study that GTN treatment for Chronic anal fissure was superior to conventional surgical treatment with respect to lessBleeding during Procedure less time to first bowel movement, less average Wound, less healing timeand less postoperative pain
Authors and Affiliations
Ajay Kumar, Mohammad Eqbal Ahmad
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