Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Management of Chronic Fissure in Ano with 2% Diltiazem Local Application (or) Lateral Internal Sphincterotomy: A Comparative Study
Maheboob Pasha, P.T. Sushanth, Gajula Vinod Reddy and T.U. Subashini
Page: 297-300 | Received 12 Aug 2024, Published online: 26 Oct 2024
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Abstract
Fissure in ano is one among the most common ano-rectal disorders encountered in surgical practice and management ranges from topical ointments to surgical sphincterotomies. Chronic anal fissure has traditionally been treated by lateral internal sphincterotomy, an effective and standard procedure but as with any surgical procedure, it is not devoid of surgical stress and complications. Topical Diltiazem 2% gel is the most commonly used pharmacological agent for treating chronic fissure in ano with variable success rates. Our study aims to compare the efficacy of Diltiazem 2% gel with lateral internal sphincterotomy. This prospective comparative study was conducted by selecting 60 cases presenting with symptoms and signs suggestive of chronic fissure in ano with specific inclusion and exclusion criteria. The study population was divided into two groups of 30 patients each. Group A was treated with topical application of Diltiazem 2% gel and Group B was taken up for lateral internal sphincterotomy. The outcome regarding the fissure healing, pain relief, any adverse effect and the recurrence was collected by the use of a pretested proforma and data concerning the 2 groups were then compared. In our series, the maximum incidence was in the age group of 21-30yrs (54%). The sex incidence ratio was 1.14:1 in favor of males. All cases presented with painful defecation and most common location of fissure was posterior midline. The final cure rates for both the groups were 83.33% in Chemical sphincterotomy and 100 % in lateral internal sphincterotomy. The conversion rate and recurrence rate were 16.33 % and 13.33% respectively in Group A while nil recurrence in Group B. The drawbacks were unique to their respective groups. Group A had headache (16.7%) and itching (23.33%) as its unique side effects. Group B patients had Post-Operative Pain (36.66%), surgical site bleeding (26.66%), surgical site infections (13.33%) and temporary fecal incontinence (23.33%). Topical application of Diltiazem 2% gel could be used as first line treatment for chronic anal fissures thereby avoiding trauma of surgery.
How to cite this article:
Maheboob Pasha, P.T. Sushanth, Gajula Vinod Reddy and T.U. Subashini. Management of Chronic Fissure in Ano with 2% Diltiazem Local Application (or) Lateral Internal Sphincterotomy: A Comparative Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.11.297.300
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.11.297.300