چکیده (انگلیسی):

Objective: Chronic anal fissure is a benign disorder that is associated with considerable
discomfort. Surgical treatment in the form of lateral sphincterotomy has long been regarded
as the gold standard of treatment. This study compared the open and closed techniques
of lateral sphincterotomy in terms of their postoperative outcomes.
Methods: A prospective, randomized comparative study was conducted between October 2010
and August 2012. A total of 136 patients were randomly assigned to each of two groups. Patients
were followed up postoperatively for more than 1 year to assess any complications.
The outcomes were compared among the two groups using the Chi-square test and Student
t test.
Results: The mean age at presentation was 40.13 years. The male to female ratio was 1.47:1.
The typical presentation was painful defecation. Fissures were most often located in the posterior
midline and associated with a sentinel pile. Delayed postoperative healing was found in
4.4% of the group of patients undergoing open lateral sphincterotomy. The mean pain score
and duration of hospital stay were lower with the closed technique.
Conclusion: Closed lateral internal sphincterotomy is the treatment of choice for chronic fissures
as it is effective, safe, less expensive, and associated with a lower rate of complications
than the open sphincterotomy technique.