Now a days, eating habits of general public is switching on to low fiber diet leading to constipation and subsequently to anal fissure. It causes ischemia in the anal lining. Constipation, elevated anal pressure and ischemia produces a vicious cycle leading to chronic anal fissure which just refuses to heal causing significant morbidity. The present study aims to evaluate safe and effective surgical method for the treatment of chronic anal fissure in the form of subcutaneous lateral internal sphincterotomy. We conducted a prospective study comprising of 58 patients suffering from chronic anal fissure from June 2017 to June 2019. Subcutaneous lateral internal sphincterotomy was done and patients were evaluated for pain relief, complications and recurrence rates. Almost all patients (94.82%) had complete pain relief after 8 weeks. Per rectal minimal bleeding for 2-3 days post operatively was the most common complication (25-86%) while a temporary incontinence to flatus was seen in 5.1% of the patient. No incontinence to stool was seen. No recurrence was seen in the follow-up period of 8 months. We found subcutaneous lateral sphincterotomy safe and effective treatment method for chronic anal fissure.

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Kanchan Sonelal Baitha

Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India