Aim: To Prospectively assess and evaluate the results of maximum anal dilatation with fissurectomy v/s lateral anal sphincterotomy among the patients with fissure in ano.

Materials and Methods: A prospective comparative study was conducted at Vinayaka Missions Kirupananda Variyar Medical college and Hospital, Salem during the period between June 2013 –June 2015. 50 patients of fissure in ano were included in the study. After getting the written informed consent from the patients 25 patients were treated with maximum anal dilatation with fissurectomy and the other 25 patients had undergone the lateral anal sphincterotomy procedure for the fissure in ano.

Results: All the operated patients were followed up for a period of 3 months and the findings seen at the end of 3 months of follow up were bleeding  was not present  in both the maximum anal dilatation (MAD) with fissurectomy and lateral anal sphincterotomy group whereas all other features like pain, persistent spasm, fecal incontinence and delayed wound healing were present in almost 50% patients in the maximum anal dilatation with fissurectomy group and none of the patients had any of these features in lateral sphincterotomy group and the difference was found to be statistically significant.(p < .0001).

Conclusion: In the surgical treatment of chronic anal fissure not responding to conservative management, lateral internal sphincterotomy may be the better Treatment and perhaps the preferable surgical technique with fewer total complications when compared with maximum anal dilatation with Fissurectomy.

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Dr R. Manoj Chandran

Post Graduate Student, Dept of Surgery

Vinayaka Missions Kirupananda Variyar Medical College, Vinayaka mission University, Salem, Tamil Nadu