Frequency of Post-Operative Fecal Incontinence and Healing Rate in Patients with Open and Closed Lateral Internal Anal Sphincterotomy

Authors

  • Muhammad Shah Khyber girls medical college
  • Muhammad Usman Hayatabad Medical Complex Peshawar
  • Jamshed Alam Hayatabad Medical Complex Peshawar
  • Imran Uddin Khan Hayatabad Medical Complex Peshawar
  • Shimee Shehzadi khyber girls medical college peshawar
  • Shehzad Akbar Khan Hayatabad Medical Complex Peshawar

DOI:

https://doi.org/10.37762/jgmds.9-4.362

Keywords:

Sphincterotomy, Closed Method, Open Method , Fissure, Healing, Fecal Incontinence

Abstract

OBJECTIVES

This study aims to compare the frequency of fecal incontinence and healing rate in patients treated with Open Internal Anal Sphincterotomy (OIAS) and Closed Lateral Internal Anal Sphincterotomy (CLIAS).

METHODOLOGY

This randomized control trial was carried out in the Department of Surgery Hayatabad Medical Complex, Peshawar Pakistan from Feb 2019 to Feb 2020. Eighty-four patients were assigned to the open method in Group B while eighty-four patients were allocated to the closed method in Group A (using blade 11) through the randomized control trial method. Fecal incontinence and healing rate were observed on the 7 th postoperative day. SPSS 23.0 software was used to analyse the data.

RESULTS

In group A out of a total of 84 patients, 96% of patients were in category A, 4% of patients were in category B, and no patients were in categories C and D. In group B out of 84 patients, 96% of patients were in category A while 4% patients were in category B and no patients were in category C and D. The total faecal incontinence in Group B (open method) was 21% while total fecal incontinence in Group A (closed method) was only 4% that is a clear dierence between the two groups. In group A (closed method) out of 84 patients, 2 patients (2.38 %) showed delayed healing while 82 patients (97.61 %) showed normal healing. In group B (open method) 7.4% of patients showed delayed healing with a signicance p level of 0.04 while 92.85 showed normal healing.

CONCLUSION

Fecal incontinence was less in closed Lateral Anal Sphincterotomy due to the use of blade 11 while it was higher in open internal anal sphincterotomy. Similarly, the healing rate was signicantly higher in the closed method while delayed healing was seen in the open method.

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Author Biography

Muhammad Shah, Khyber girls medical college

Khyber girls medical college

References

Pandit RK, Jha VK. Lateral internal sphincterotomy versus anal dilatation in chronic anal fissure-an observational study. Int. J. Health Sci. Res. 2019;9(10):105-10

Jin JZ, Bhat S, Park B, Hardy MO, Unasa H, Mauiliu-Wallis M, Hill AG. A systematic review and network meta-analysis comparing treatments for anal fissure. Surgery. 2022 Jan 5

Jain BK, Sharma N, Gupta H. Lateral internal partial sphincterotomy technique for chronic anal fissure: an avoidable risk to the surgeon’s finger. Indian Journal of Surgery. 2018 Apr 1;80(2):203-4

del Mar Aguilar M, Moya P, Alcaide MJ, Fernández A, Gómez MA, Santos J, Calpena R, Arroyo A. Results of the national survey on the treatment of chronic anal fissure in Spanish hospitals. Cirugía Española (English Edition). 2018 Jan 1;96(1):18-24

Kumar D, Negi A, Kumar N, Pandey A. A prospective, randomize study of comparison of lateral internal sphincterotomy versus Lord’s anal dilatation in chronic anal fissure. International Surgery Journal. 2018 Feb 26;5(3):1026-30

Joda AE, Al-Mayoof AF. Efficacy of nitroglycerine ointment in the treatment of pediatric anal fissure. Journal of pediatric surgery. 2017 Nov 1;52(11):1782-6

Salih AM. Chronic anal fissures: Open lateral internal sphincterotomy result; a case series study. Annals of Medicine and Surgery. 2017 Mar 1;15:56-8

Krogh K, Chiarioni G, Whitehead W. Management of chronic constipation in adults. United European gastroenterology journal. 2017 Jun;5(4):465-72

Acar T, Acar N, Güngör F, Kamer E, Güngör H, Candan MS, Bağ H, Tarcan E, Dilek ON, Haciyanli M. Treatment of chronic anal fissure: Is open lateral internal sphincterotomy (LIS) a safe and adequate option?. Asian journal of surgery. 2019 May 1;42(5):628-33

Anandaravi BN, Ramaswami B. Closed versus open lateral internal anal sphincterotomy in a chronic anal fissure. International Surgery Journal. 2017 Feb 25;4(3):1055-8

Bara BK, Mohanty SK, Behera SN, Sahoo AK, Swain SK. Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure: A randomized control trial. Cureus. 2021 Sep 28;13(9)

Rodrigues BD, Reis IG, Coelho FM, Buzatti KC. Fecal incontinence and quality of life assessment through questionnaires. Journal of Coloproctology (Rio de Janeiro). 2017 Oct;37:341-8

Poh A, Tan KY, Seow-Choen F. Innovations in chronic anal fissure treatment: A systematic review. World J Gastrointest Surg 2010;2(7):231–41

Brillantino A, Izzo D, Iacobellis F, Maglio M, Grillo M, Vicenzo L, Bottino V, Renzi A. Safety and effectiveness of minimal sphincterotomy in the treatment of female patients with chronic anal fissure. Updates in Surgery. 2021 Oct;73(5):1829-36

Emile SH, Elgendy H, Elfeki H, Magdy A, Abdelmawla AA, Abdelnaby M, Khafagy W. Does the duration of symptoms of anal fissure impact its response to conservative treatment? A prospective cohort study. International Journal of Surgery. 2017 Aug 1;44:64-70

D’Orazio B, Sciumé C, Famà F, Bonventre S, Martorana G, Calì D, Terranova G, Di Vita G, Geraci G. Surgical sphincter saving approach and topical nifedipine for chronic anal fissure with hypertonic internal anal sphincter. Chirurgia. 2020 Sep 1;115:585-94

De Robles MS, Young CJ. Real world outcomes of lateral internal sphincterotomy vs botulinum toxin for the management of chronic anal fissures. Asian Journal of Surgery. 2022 Jan 1;45(1):184-8

Hashmat A, Ishfaq T. Chemical versus surgical sphincterotomy for chronic fissure in ano. J Coll Physicians Surg Pak 2007;17(1):44–7

Sebastiano L, Fabio M. Anal fissure: Over 30 year’s experience. Prev Med. 2019;2:1-3

Almas T, Mansour E, Niaz MA. Outcome of Treatment of Anal Fissure by Closed Lateral Internal Sphincterotomy Operated With Von Greaves (Cataract Knife). INTERNATIONAL JOURNAL OF ADVANCED BIOTECHNOLOGY AND RESEARCH. 2018 Jan 1;9(4):574-8

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Published

2022-10-02

How to Cite

Shah, M., Muhammad Usman, Jamshed Alam, Imran Uddin Khan, Shimee Shehzadi, & Shehzad Akbar Khan. (2022). Frequency of Post-Operative Fecal Incontinence and Healing Rate in Patients with Open and Closed Lateral Internal Anal Sphincterotomy. Journal of Gandhara Medical and Dental Science, 9(4), 80–84. https://doi.org/10.37762/jgmds.9-4.362

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