A Prospective study to evaluate Medical Management vs Surgical Intervention in anal fissure

  • Puneet Agrawal
  • Avanish Kumar Saxena
  • Abhishek Yadav
  • Zainuddin Liyakat Parkar FH Medical College and Hospital, Agra
  • Nitish Jain
  • Prakhar Verma
  • Radhika Sahni


Introduction: Anal fissure is a commonly encountered problem for surgeons. It is a longitudinal tear in distal anal canal with or without an ulcer. It causes significant changes in quality of life. This study was done to compare the efficacy of medical management and surgical intervention in cases of anal fissures.
Methods: 50 patients were divided into two groups of 25 each. Group A patients were treated with topical application of 2% diltiazem gel and Group B patients were treated with Lateral sphincterotomy. Both groups were examined weekly for 4 weeks for pain using VAS score and at 12 weeks for healing.
Results: 21(84%) patients were pain free after 4 weeks under Group A, 24 (96%) patients were pain free after 4 weeks under Group B. 22(88%) patients were completely healed at 12 weeks under Group A, 25(100%) patients were completely healed at 12 weeks under Group B.
Conclusion: Lateral sphincterotomy can be advocated as treatment of choice for anal fissures. It has better pain relief and healing rates compared to topical application of 2% diltiazem gel. Medical Management can be used in patients refusing surgery or unfit for surgery.


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How to Cite
AGRAWAL, Puneet et al. A Prospective study to evaluate Medical Management vs Surgical Intervention in anal fissure. J Soc Surg Nep, [S.l.], v. 26, n. 1, p. 11-15, aug. 2023. ISSN 2392-4772. Available at: <https://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=519>. Date accessed: 22 sep. 2023.