Upshot of Open Lateral Internal Sphincterotomy And Arkaksharsutra (caustic therapy) In the Treatment of Fissure-In-Ano W.S.R To Fissure in ano: One Centre Experience

Abstract

Background: The word Fissure in ano as a whole means “to cut circumferentially” or to cut all around.  Fissure in ano resembles fissure-in-ano which is amongst the common painful condition occuring in the  anorectal region. Ksharasutra (Caustic therapy) is a parasurgical procedure effective in the management of  Fissure in ano. Aim: To compare the efficacy of Arka Ksharasutra (Caustic therapy) and open lateral internal  sphincterotomy (OLIS) in the management of Fissure in ano. Methodology: Total 30 patients having signs and symptoms of fissure-in-ano were selected and randomly  divided into two groups. In Group A (n=15), Arka Ksharasutra (Caustic therapy) ligation after anal stretching  was carried out while in Group B (n=15), OLIS with excision of skin tag was carried out under local  anesthesia or spinal anesthesia. Relief in postoperative symptoms and complications (if any) were recorded  for 4 weeks and follow-up was done for 1 month. Results: In both the groups, significant results were obtained, but the difference among groups was  statistically insignificant. Duration required for postoperative symptoms like pain, bleeding, swelling and  wound healing to subside was found to be more in Group A(Ksharsutra (Caustic therapy) than Group B  (OLIS). Conclusion: Open lateral internal sphincterotomy (OLIS) provided better results than Ksharasutra (Caustic  therapy) ligation in the management of Fissure in ano.