MANAGEMENT OF CHRONIC ANAL FISSURES
Keywords:
Botulinum toxin, lateral internal sphincterotomy, chronic anal fissure, healingAbstract
Objective: To compare the effectiveness of Botulinum toxin injection with lateral internal sphincterotomy for the treatment
of chronic anal fissure in terms of healing.
Material & Methods: This study was conducted in surgical unit Hayatabad Medical Complex Peshawar from April 2013 to April 2014 .In this comparative study a total of 396 patients of chronic anal fissure were admitted in surgical department on the basis of inclusion and exclusion criteria patients were divided into two groups, A and B (198 patients in each group) ,depending upon type of treatment option(leteral shincterotomy or Botulinum toxin) for chronic anal fissure. After detail history and clinical examination, all patients were investigated and were prepared for the procedure. All data analyses were performed using the SPSS version 10.
Results: A total of 396 patients of chronic anal fissure were observed, which were divided in two equal groups. Overall Male to female ratio was 1.25:1. Sex distribution among the groups was insignificant with p-value=0.069 Average age was 45.11 years+ 13.26SD in group A and group B have average age of 45.74 years +14.28SD. The age distribution among the group was also insignificant with p-value 0.707. Efficacy was significant in both the procedure with p-value=0.045.
Conclusion: Botulinum toxin injection is more effective then lateral internal sphincterotomy in the management of chronic anal fissure.
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