European Journal of Cardiovascular Medicine

Background: Fissure in ano is a common anorectal condition associated with high sphincter pressure and a reduction in mucosal blood flow, with secondary local ischemia and a poor healing tendency. The principle of treatment is breaking the cycle of pain, spasm, and ischemia thought to be responsible for the development of fissure in ano. Objective: The objective of our study is to compare the outcome of lateral internal sphinctereotomy and application of topical 0.2%  glyceryl trinitrate for the treatment of anal fissure. Methods: This prospective comparative study was conducted at department of surgery bundelkhand medical college and associated hospital sagar (MP) from september 2021 to october 2022. Total 60 patients with anal fissure were included in the study. After the diagnosis of anal fissure and before  starting treatment, a detailed scenario of its treatment, process, side effects, and healing and complication were explained to patients then consent was signed by the individual patients. Patients were divided into two groups to compare the outcomes of both lateral internal sphincterotomy and application of 0.2% glyceryl trinitrate ointment. Group A had 30 patients and Group B had 30 patients as well. Both group were followed up to six weeks. Results: In this study, males were commonly affected than females. The most common age group were 41-50yrs. Majority of the patients presented with pain during defecation. Constipation was the major predisposing factor among all cases. Most of the anal fissure were located in the posterior midline. The final comparison after six weeks of treatment shows the 83.3% of patients healed with the lateral sphincterotomy and 46.6% of patients healed with application of topical ointment of 0.2% glyceryl trinitrate. Complication of glyceryl trinitrate is headache which occurred in majority of patients. Pain is the most common post operative complication of lateral internal sphincterotomy. Conclusion:  We concluded that lateral internal sphincterotomy has an effective response to treat the anal fissure as compare to application of 0.2% glyceryl trinitrate ointment with advantages of good symptomatic relief, high rate of healing