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Category: Volume 07 Issue 07 July 2019
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Title: A Comparative Study of Topical Glyceryl Trinitrate (0.2%) and Lateral Anal Sphincterotomy in Treatment of Fissure in Ano

Authors: Dr Dunna Vasanth, Dr Naga Karthik Garikaparti, Lakshmi Venkata Simhachalam Kutikuppala, Dr Moturi Santhoshi Mounika, M.V. Sathvika

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.131

Abstract

Introduction: Anal fissure is a common condition affecting all age groups, but it is seen particularly in young and otherwise healthy adults, with equal incidence across the genders. Glyceryl Tri Nitrate(GTN) is an NO donor which causes relaxation of internal anal sphincter and increases blood flow to allow the fissure to heal. Lateral internal anal sphincterotomy is the most common treatment for chronic anal fissure and can be effective.

Aims and Objectives

  • To study the aetiology and predisposing factors, age and sex incidence, clinical presentation, position of fissure and associated features.
  • To study complications associated with medical and surgical management of anal fissure and to compare Glyceryl TriNitrate (0.2%) over Lateral Internal anal sphincterotomy.

Materials and Methods: Study Population was made of 60 patients who presented with chronic anal fissure, divided into two groups. Group A included 30 patients with chronic anal fissure treated with local glyceryl trinitrate ointment 0.2% whereas Group B included 30 patients managed by lateral internal sphincterotomy.

Results: Out of 60 study participants, 39 were male and 21 were female.  Most of these patients had constipation as the major predisposing factor. 18 out of 30 patients had relief of symptoms with medical management. 27 out of 30 patients had relief of pain and healing of fissure with surgical management.

Conclusion: Lateral sphincterotomy remains effective but should be reserved for the patients who fail to respond to initial chemical sphincterotomy or GTN therapy.

Keywords: Anal Fissure, Glyceryl Tri Nitrare (GTN), Lateral Internal Anal Sphincterectomy (LIAS), Medical, Surgical.

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Corresponding Author

Lakshmi Venkata Simhachalam Kutikuppala

Final MBBS Part-1, 156 batch, Department of General Surgery, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India, 533201