Comparative study of Glyceryl Trinitrate ointment versus lateral internal sphincterotomy in management of Chronic anal fissure.

摘要

Objectives: To compare efficacy of topical 0.2% glyceryl trinitrate ointment withlateral internal sphincterotomy in treatment of patients with chronic anal fissure. Study Design:Randomized Control Trial. Setting: Department of General Surgery, DHQ Teaching Hospital,Sahiwal. Period: From 20 September 2016 to 31 December 2017. Material & Methods: A totalnumber of 60 patients included in this study and divided into two groups GTN and LIS groupthrough computer generated randomization method. Three main outcome variables wereassessed in this study; pain relief, healing of fissure and recurrence. SPSS version was usedto analyze data. P value ≤ 0.05 was considered as significant. Results: A total number of 60patients included in this study. Relief of pain GTN and LIS was (95%) and (86.7%) respectively.Fissure healing GTN and LIS was noted as (88.3%) and (83.3%) respectively. Recurrence was notfound in any patient of the present study. Relief of pain was statistically significant. Conclusion:Topical application of GTN ointment for relief of pain is safe and effective method for reliefof chronic anal fissure but pain relief is slow. On other hand lateral internal sphincterotomyis first line treatment and treatment of choice for chronic anal fissure when performed by anexperienced surgeon.