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Anal fissure is one of the commonest and painful proctologic diseases encountered in routine clinical practice causing considerable morbidity and reduction in quality of life. There are medical and surgical treatment options for anal fissure. The chronic fissures behave more differently in that way they are more persistent and relapsing than the acute fissures which are self-healing.Aims and Objectives: To compare the outcomes of open lateral internal sphincterotomy and closed lateral internal sphincterotomy using cataract knife in terms of duration of surgery, postoperative pain, faecal and flatus incontinence, duration of hospital stay.Materials and Methods: In this prospective study, 100 patients admitted with Chronic Fissure in Ano were randomly divided into Group A {Open Lateral Internal Sphincterotomy} And Group B {Closed Lateral Internal Sphincterotomy Using Cataract Knife} with 50 patients in each group. Regular follow up was done at weekly intervals for four consecutive weeks and biweekly for subsequent 2months.Results: In our study most of the patients fall under the age group of 25 to 50 years. And out of 100 patients, 46patients were female and 54 were male patients. Duration of surgery, postoperative pain, fecal and flatus incontinence, duration of hospital stay were better among patients who underwent closed lateral sphincterotomy when compared with open lateral sphincterotomy patients group.Conclusion: In our study it was observed that GROUP B has better outcomes in terms of duration of surgery, postoperative pain, fecal and flatus incontinence, recurrence when compared with GROUP A patients. Thus the present study concludes that the closed lateral sphincterotomy using cataract knife should be used as the primary treatment of choice in the management of chronic fissure in ano.

A comparative study between open and closed lateral internal sphincterotomy using Cataract knife in patients with chronic fissure in ANO