COMPARISON OF SURGICAL AND CONSERVATIVE METHODS FOR TREATING CHRONIC ANAL FISSURES

Abstract

Background: In addition to the gold standard lateral sphincterotomy method, several non-surgical treatments are also used to treat chronic anal fissures. This was carried out in order to enhance technique and remove the surgical approach, enabling conservative procedure. 
Aim: The purpose of the current study was to evaluate various therapeutic approaches for the treatment of chronic anal fissures and to determine whether there was a relationship between the treatment's reduction in sphincter pressure and discomfort.  
Methods: In order to get either surgical or medical therapy, the study evaluated 204 participants who were split into two groups of 102 subjects each at random. A lateral internal sphincterotomy was performed on 100 participants in Group I, while 104 subjects were treated with 0.2% glyceryl trinitrate ointment. Before and after therapy, mean sphincter and basal pressures as well as VAS values were used to objectively measure pain. All individuals' fissure healing was evaluated four to six weeks following the end of therapy.  
Results: the surgery group saw a considerably greater reduction in pain scores than the non-surgical group (p=0.03). Sphincter pressure decreased much more in the surgical group (25.08) than in the conservative group (6.54, p<0.001). The surgical group had significantly greater fissure healing rates, and there was a strong association between anal canal discomfort and MASP decrease (p=0.000). 
Conclusion: Compared to participants undergoing conservative chronic anal fissure therapy, those undergoing surgical management exhibit considerably greater reductions in sphincter pressure, discomfort, and fissure healing.